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CMS Issues Rule Implementing Medicaid Redetermination Policies

We’ve written recently about the process that states are undertaking to begin to wind down the Medicaid enrollment expansion that was necessitated by the enactment of the Families First Coronavirus Response Act in March of...more

The Supreme Court’s Talevski Decision: Medicaid Private Enforcement under Section 1983 Lives to See Another Day

Today’s post provides an important update on the Supreme Court case Health & Hospital Corporation of Marion County (HHC) v. Talevski. As readers will remember, our blog has been following this case since it made its way to...more

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

Renewed Focus on Medicaid Home and Community-Based Services

Due to the COVID-19 pandemic, most people have spent considerably more time at home over the past year. For many, this meant long hours of Netflix binging, crossword puzzles, and the occasional zoom happy hour. But for some...more

President Biden Takes First Step Towards Reversing Trump Era Medicaid Policies

On January 28th, President Biden issued an “Executive Order on Strengthening Medicaid and the Affordable Care Act.” The E.O. states that the Biden Administration will promote policies that “protect and strengthen Medicaid and...more

The 340B Contract Pharmacy Saga Continues

Donald Trump extended two directives restricting the admission of certain immigrants and nonimmigrants to the U.S. Specifically, Presidential Proclamation (PP) 10014 restricting the admission of first-time immigrants and PP...more

CMS Releases the New Medicaid Managed Care Final Rule

On November 9, 2020, the Centers for Medicare and Medicaid Services (“CMS”) announced it finalized the Medicaid and Children’s Health Insurance Program (“CHIP”) Managed Care final rule (“2020 final rule”). According to CMS,...more

The 340B Contract Pharmacy Saga

We are back again with another 340B post. The 340B program has recently been a regular feature on the blog in the context of ongoing litigation discussed here and here. Today, we wanted to provide readers the details of an...more

A Loss in SCOTUS Prompts New CMS Notice of Proposed Rulemaking

On August 4th, CMS released a proposed rule titled Treatment of Medicare Part C Days in the Calculation of a Hospital’s Medicare Disproportionate Patient Percentage (DPP). We’ve written before about the Medicaid...more

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