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State and Local Government Managed Care Contracts

Foley Hoag LLP - Medicaid and the Law

CMS Rings in the New Year with Updated Guidance on ‘In Lieu of Services and Settings’ (ILOS) in Medicaid Managed Care

Welcome back! We hope everyone had a great start to 2023. A new year provides an opportunity to look back on previous successes and identify areas for growth (this said, we certainly don’t expect everyone to make—let alone...more

Foley Hoag LLP - Medicaid and the Law

Oregon’s New Waiver Request to Exclude Accelerated Approval Drugs from Medicaid Coverage

Hello readers! Today’s post focuses on a topic we’ve touched on a few times in the past – Medicaid drug formularies. Back in December 2021, the state of Oregon released a draft Medicaid waiver proposal that caught the...more

Manatt, Phelps & Phillips, LLP

New York State SFY23 Executive Budget Health Focus Highlights

On January 18, 2022, Governor Kathy Hochul released her budget proposal for State Fiscal Year 2023. While record-breaking in its size—totaling $216.3 billion—and inclusive of many investments in Medicaid and health care more...more

Bass, Berry & Sims PLC

The California Insurance Frauds Prevention Act: What to Know About California’s Powerful Commercial Health Insurance Fraud Statute

Bass, Berry & Sims PLC on

Although this blog focuses mainly on the federal False Claims Act (FCA), other antifraud statutes feature in the qui tam relator and government enforcement toolkit. Key among them: the California Insurance Frauds Prevention...more

Farrell Fritz, P.C.

The Broadest Impact:  2018-19 New York State Managed Care Budget Highlights

Farrell Fritz, P.C. on

This, the last of our posts on the 2018-19 New York State Health Budget (the “Enacted Budget”), focuses on an area of healthcare that has perhaps the broadest impact of the sector as a whole — managed care. ...more

Farrell Fritz, P.C.

A Renewed Focus: 2018-19 New York State Intellectual and Developmental Disabilities Budget Highlights

Farrell Fritz, P.C. on

Since the beginning of the administration of Governor Andrew Cuomo, there has been a strong emphasis on reform of the acute, primary, and long term care systems, and, particularly with the recent focus on the opioid crisis,...more

Farrell Fritz, P.C.

2018-19 New York State Healthcare Budget

Farrell Fritz, P.C. on

In the wee hours of the morning on March 30, almost two days ahead of the April 1 deadline, the Legislature passed and the Governor signed a $168.3 billion State Budget for the 2018-19 fiscal year. ...more

Nossaman LLP

Abrupt Closure of SynerMed Shakes Up Medical Management Industry

Nossaman LLP on

SynerMed, a Southern California-based physician management company, will be shutting down, per an email from its CEO earlier this month. Recently, the company had come under increasing scrutiny by health plans and California...more

Roetzel & Andress

STATE BUDGET UPDATE: In A Historic Move, House Votes To Override 11 of the Governor's Vetoes From State Budget

Roetzel & Andress on

The last time the Legislature voted to override multiple state budget vetoes was exactly forty (40) years ago to this day on July 6, 1977 under then Governor James Rhodes (R) and former longtime House Speaker Vern Riffe (D)....more

Roetzel & Andress

Governor Kasich Releases $144 Billion State Budget Proposal - What You Need to Know

Roetzel & Andress on

Yesterday, Governor Kasich released the executive version of the state’s two-year operating budget (Fiscal Years 2018-2019), which includes proposed spending of over $144 billion during the biennium. Similar to his previous...more

Clark Hill PLC

Texas OIG Turns Over New Leaf: MCOs Must Turn Attention to SIUs

Clark Hill PLC on

More active SIUs may mean more scrutiny of Medicaid providers - The Texas Office of Inspector General (OIG) has just completed its first full year of reforms under a new Inspector General. 2017 may reveal whether these...more

Manatt, Phelps & Phillips, LLP

Manatt on Medicaid: Leveraging MMC Contracts to Advance Reforms

Editor's Note: This “Manatt on Medicaid” is the fourth in a series of updates focused on CMS’s new Medicaid/CHIP managed care regulations. In the coming weeks, Manatt will be exploring key provisions of the regulations and...more

Moore & Van Allen PLLC

North Carolina Legislative Report

Moore & Van Allen PLLC on

The General Assembly convened for the 2015 legislative long session on January 14 and adjourned September 30. Lawmakers will return to Raleigh for the short session April 25, 2016. The MVA Public Affairs Legislative Report on...more

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