Earlier this year, we wrote about a lawsuit involving the 340B drug pricing program. We sometimes write about the 340B program because it is integrally linked to the Medicaid prescription drug rebate program. So today, we...more
Earlier this week, CMS released for publication a proposed rule that would add some degree of transparency and oversight to the somewhat opaque world of Medicaid financing. It’s a topic that’s fascinated us here at the...more
11/18/2019
/ Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Disproportionate Share Adjustments ,
Fee-for-Service ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Medicaid ,
Proposed Rules ,
Social Security Act ,
State Budgets
For much of the past two years, enrollment in the Medicaid and CHIP programs has been declining. In May, 2017, enrollment in both programs was 74.6 million people. As of May of this year, enrollment had declined by 2.5%, to...more
11/5/2019
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Department of Homeland Security (DHS) ,
Foreign Nationals ,
Health Insurance ,
Income Taxes ,
Individual Mandate ,
Internal Revenue Code (IRC) ,
Low-Income Issues ,
Medicaid ,
Medical Benefits ,
Modified Adjusted Gross Income ,
Tax Reform
Last Fall, we wrote about a proposed regulation issued by the Department of Homeland Security that involved one of our favorite topics: the intersection of immigration and health care law. My colleague Christian Springer and...more
8/19/2019
/ Adjudicatory Process ,
Department of Homeland Security (DHS) ,
Department of Justice (DOJ) ,
Final Rules ,
Immigrants ,
Immigration and Nationality Act ,
Medicaid ,
OMB ,
Proposed Rules ,
Public Benefits ,
USCIS ,
VAWA
Last week, CMS issued a proposed rule as part of a broader Administration-wide initiative to reduce regulatory and administrative burdens. The proposed rule would absolve states from many of the requirements of a final...more
On June 19, the House of Representatives passed the funding bill for the Department of Health and Human Services for fiscal year 2020. CMS is funded in this annual legislation and this funding bill is often a vehicle for...more
Since the beginning of this year’s legislative session, Governor Baker has expressed concern over the growth in enrollment in MassHealth, the state’s Medicaid program. A look at the numbers explains why. Prior to the...more
Early on Thursday morning, March 9, the Committee on Ways and Means of the U.S. House of Representatives passed legislation that would fundamentally restructure the Affordable Care Act (or, as it is sometimes colloquially...more
Market Based Payment for Clinical Diagnostic Laboratory Tests -
Summary -
On June 17, 2016 the Centers of Medicare & Medicaid Services (CMS) issued the long awaited Medicare Clinical Diagnostic Laboratory Tests...more
7/5/2016
/ ADLT ,
Algorithms ,
Centers for Medicare & Medicaid Services (CMS) ,
CLFS ,
Clinical Laboratories ,
Clinical Laboratory Testing ,
Comment Period ,
Data Collection ,
Diagnostic Tests ,
MACs ,
Medicaid ,
Medicare ,
Medicare Advantage ,
PAMA ,
Payment Systems ,
Proposed Regulation ,
Provider Payments ,
Reporting Requirements
On January 21, 2016, the Centers for Medicare & Medicaid Services (CMS) released the final rule implementing the prescription drug rebate provisions enacted as part of the health care reform law, the Affordable Care Act...more
On December 8, 2003, the Medicare Prescription Drug, Improvement, and Modernization Act (the “MMA”) was signed into law by former President George W. Bush1. Prior to the enactment of the MMA, Medicare prescription drug...more