A second lawsuit has been filed challenging recent changes to New York's Consumer Directed Personal Assistance Program (CDPAP or the Program), this time taking aim at the new single fiscal intermediary (FI) structure that...more
On January 9, 2024, the Centers for Medicare & Medicaid Services (CMS) approved New York’s recent 1115 demonstration waiver. Among other things, this most recent demonstration waiver provides significant federal funding...more
The Big Picture - In recognition of the impact of health-related social needs (HRSNs), the Centers for Medicare & Medicaid Services (CMS) issued a new Informational Bulletin and accompanying framework on November 16, which...more
Drivers of Health (DOH)—the conditions under which people live, learn, work, play and age—are proven to have a greater impact on health than medical care. As evidence mounts for the importance of DOH in driving health...more
Governor J.B. Pritzker recently signed into law the “Illinois Health Care and Human Service Reform Act” (Act). The purpose of the Act is to address inequality in the delivery of health care services in Illinois. While many...more
The New York State Office of the Medicaid Inspector General (OMIG) instituted changes to its annual compliance certification process, effective immediately. These changes apply to those Medicaid, Managed Medicaid, and Service...more
New York State has enacted amendments to provisions of the Social Services Law governing the compliance program requirements applicable to Medicaid providers. These changes generally took immediate effect on April 1, 2020,...more
On Tuesday, June 9, the U.S. Department of Health and Human Services (HHS) announced in a press release that it expects to distribute approximately $15 billion from the Public Health and Social Services Emergency Fund (Relief...more
While the fight in Washington has been focused on the future of Obamacare, here in New York a healthcare revolution is well underway. Over the past several years, major changes in New York healthcare laws and regulations have...more
California - Medicaid Enrollees Are Largest Share of Newly Insured - A new survey from the Kaiser Family Foundation found that 33% of Californians uninsured in 2013 are now enrolled in Medi-Cal, the State’s Medicaid...more
CMS’ increase of the “income verification threshold” makes eligibility determinations easier for consumers; Oregon CO-OP policyholders can credit out-of-pocket spending towards new plans; and report finds that 13 million...more
Massachusetts’s Marketplace eliminates cost-sharing for addiction treatment in subsidized QHPs; Montana cuts its uninsurance rate in half; and a Kaiser report identifies the 50 most costly drugs for Medicaid....more