News & Analysis as of

California Medicaid

Nossaman LLP

Continuity of Care vs. Exclusive Contracting: What an Ongoing Dispute over a Hospital’s Exclusive Services Agreement Means for...

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With many hospitals turning to exclusive contracts to manage clinical services, understanding when statutory protections may be violated or when contracting decisions run opposed to medical staff bylaws is crucial. In a...more

McDermott Will & Schulte

Trending in Telehealth: June 2025

Trending in Telehealth highlights monthly state legislative and regulatory developments that impact the healthcare providers, telehealth and digital health companies, pharmacists and technology companies that deliver and...more

Davis Wright Tremaine LLP

Two California Appellate Decisions Highlight Liability Risks Arising From Hospital "Conditions of Admission" Forms and Billing...

In the ever-evolving world of healthcare billing, two recent reported California appellate court decisions, Naranjo v. Doctors Medical Center of Modesto and Dameron Hospital Association v. Progressive Casualty Insurance...more

Troutman Pepper Locke

California AG Takes Action Against $1.3 Million Insurance Fraud Scheme

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In May, California’s attorney general (AG) charged a local dermatologist with more than 20 counts of fraud after uncovering a scheme that allegedly resulted in the state’s Medicaid program paying out over $1.3 million for...more

Fennemore

California’s Bold Experiment with Whole-Person Centered Care: Has it Worked?

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CalAIM is an initiative of the California Department of Health Care Services (the Department) to improve the quality of life and health outcomes of Medi-Cal members by implementing delivery system, program, and payment...more

Foley & Lardner LLP

California Agency Cracks Down on High-Cost Hospitals

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California’s Office of Health Care Affordability (OHCA) is moving beyond broader policy-setting and into direct intervention at the provider level — a shift all hospitals and health systems across the state should take...more

Cozen O'Connor

Cozen Currents: The Regulatory State(s)

Cozen O'Connor on

“With the Trump administration’s aggressive plans for a rollback of federal regulation, blue states are already looking to fill the void, demonstrating that nature abhors a vacuum in the political realm as well.” — Howard...more

Goodwin

Health Headlines: February 2025

Goodwin on

Welcome to the third issue of Health Headlines, a newsletter created by lawyers in our Healthcare practice....more

McDermott Will & Schulte

California SB 923: New Trans-Inclusive Healthcare Requirements for Health Plans

Beginning in the first quarter of 2025, California healthcare service plans, health insurers, Medi-Cal managed care plans, and PACE organizations must ensure that staff who have direct enrollee contact receive evidence-based...more

Mintz - Health Care Viewpoints

California Health Care Legislative Update: Winter 2024

Governor Newsom signed over 1300 bills and vetoed almost 190 bills in 2024. Consistent with prior years, in 2024, California enacted multiple laws significantly impacting the health care industry. From artificial intelligence...more

Whiteford

California Department of Public Health's (CDPH) Limits On CRNA Scope of Practice Reminds Hospitals Nationwide to Revisit...

Whiteford on

The California Department of Public Health (CDPH) issued a letter on September 6, 2024, to all general acute care hospitals clarifying the scope of practice for Certified Registered Nurse Anesthetists (CRNAs) following...more

McDermott Will & Schulte

New York State Budget Institutes Revenue-Neutral Health Plan Tax

The New York State fiscal year 2024 – 2025 budget was signed on April 20, 2024, instituting, among many other provisions, a new tax on health plans, including insurers and managed care organizations. This tax has been...more

Epstein Becker & Green

California Finalizes SB 184 Pre-Transaction Notice Requirements for “Material Change” Health Care Transactions

Epstein Becker & Green on

On December 18, 2023, the California Office of Administrative Law approved the emergency regulations promulgated by the Office of Health Care Affordability (OHCA) that set forth the procedural framework for (i) the...more

Hinshaw & Culbertson - Health Care

California Prohibits PBM Discriminatory Practices Against 340B Program Covered Entities and Contract Pharmacies

The 340B Drug Program requires pharmaceutical manufacturers participating in the Medicaid program to provide covered outpatient drugs at significantly reduced prices to certain health care organizations and programs, referred...more

Foley & Lardner LLP

What’s Next for Labor and Employment Laws in California?

Foley & Lardner LLP on

The 2023 California Legislative session, which ended on September 14, 2023, saw a flurry of activity on labor and employment-related laws. Governor Newsom has until October 14, 2023, to sign, veto, or pocket veto (i.e., take...more

Mintz - Health Care Viewpoints

California Passes New Law Requiring Physicians and their Employers to Notify Patients about the Open Payments Database

A new California law (AB 1278) will require physicians and their employers to provide patients with several forms of notices about the Open Payments database, starting January 1, 2023. The law is intended to increase...more

Sheppard Mullin Richter & Hampton LLP

Medicaid and Health Equity: CalAIM’s Bold Experiment

More than 13 million people were enrolled in Medi-Cal in California in September 2021, making it the largest Medicaid program in the nation. In December 2021, the Centers for Medicare & Medicaid Services (CMS) approved the...more

King & Spalding

CMS Approves CalAIM proposal to transform California’s Medi-Cal

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On December 29, 2021, the California Department of Health Care Services (DHCS) announced CMS’s approval of its California Advancing and Innovating Medi-Cal (CalAIM) proposal. CalAIM’s launch on January 1, 2022 is part of a...more

King & Spalding

California Medicaid Set to Lose $200 Million in Funding Next Quarter for its Universal Abortion Coverage Mandate

King & Spalding on

On December 16, 2020, the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR), announced that the Centers for Medicare & Medicaid (CMS) will disallow $200 million in federal Medi-Cal funding next...more

ArentFox Schiff

Acute Care Hospital Agrees to Pay $50 Million to Settle Alleged Stark Law and Anti-Kickback Statute Violations

ArentFox Schiff on

Acute Care Hospital Agrees to Pay $50 Million to Settle Alleged Stark Law and Anti-Kickback Statute Violations - On September 9, 2020, the Department of Justice (“DOJ”) announced that Wheeling Hospital Inc. (“Wheeling...more

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