News & Analysis as of

Government Agencies Health Insurance

Ropes & Gray LLP

Hospital and Health Systems Reimbursement Check July 2025

Ropes & Gray LLP on

In the early days of the second Trump Administration, several federal funding agencies announced caps to indirect cost (“IDC”) rates for federally funded research awards. In many cases, these caps would substantially reduce...more

Cozen O'Connor

Pennsylvania Perspective for Thursday, July 10, 2025

Cozen O'Connor on

Gov. Shapiro Warns About Medicaid Cuts, Rural Hospital Closures - During a press conference in York on Monday, Governor Josh Shapiro (D) sharply criticized Pennsylvania Republicans for supporting a federal reconciliation...more

Hogan Lovells

Supreme Court affirms constitutionality of U.S. Preventive Services Task Force

Hogan Lovells on

On June 27, 2025, the Supreme Court in Kennedy v. Braidwood Management, Inc. upheld the structure of the U.S. Preventive Services Task Force (USPSTF, or “Task Force”), overturning a Fifth Circuit decision that had ruled that...more

Ballard Spahr LLP

Two Recent Supreme Court Injunction Rulings Support Affordable Care Act

Ballard Spahr LLP on

Two recent U.S. Supreme Court rulings support provisions of the Affordable Care Act, one directly and one indirectly....more

Akerman LLP - Health Law Rx

FBI Warning: Criminals Posing as Health Insurers and Fraud Investigators Are Targeting Providers and Patients

The FBI issued a warning on June 27, 2025, that criminals impersonating healthcare insurers and fraud investigators are sending text messages and emails to healthcare providers and patients to trick them into providing...more

ArentFox Schiff

Restructuring DC Health Care Alliance With New Eligibility Rules and Timelines for 2025

ArentFox Schiff on

The District of Columbia is set to implement sweeping changes to its DC Health Care Alliance, a program that has provided vital health coverage to low-income residents who do not qualify for Medicaid or Medicare, including...more

King & Spalding

Affordable Care Act Preventative Care Mandate At Risk Pending Supreme Court Decision

King & Spalding on

A case pending before the Supreme Court could jeopardize the Affordable Care Act’s (ACA) mandate that certain preventive services be provided on a first dollar coverage basis to plan members. Kennedy v. Braidwood Management...more

ArentFox Schiff

Federal Court Sides With Payers on No Surprises Act IDRE Selection Process: What Providers Need to Know Now

ArentFox Schiff on

A recent decision from the US District Court for the Eastern District of New York has significant implications for providers navigating the No Surprises Act (NSA) independent dispute resolution (IDR) process....more

King & Spalding

House Passes Reconciliation Bill Impacting Medicaid Financing, Programs, and Eligibility

King & Spalding on

On May 22, 2025, the House passed H.R. 1, the One Big Beautiful Bill Act (the Bill), its budget reconciliation legislation that upheld most of the Medicaid-related provisions originally approved by the House Energy and...more

Jones Day

Medicare's Innovation Center Charts New Direction: Part 1 - Providers

Jones Day on

The Center for Medicare and Medicaid Innovation ("CMMI") is set to reshape value-based care. In the first of a three-part series highlighting this new direction, this summary is focused on CMMI's efforts regarding health care...more

Rivkin Radler LLP

FBI Warns Consumers of Discount Medical Scams

Rivkin Radler LLP on

On April 30, the Federal Bureau of Investigation (FBI) released a Public Service Announcement warning consumers about fraudulent discount medical scams. These scams typically involve deceptive offers for health insurance...more

Stotler Hayes Group, LLC

Common Medicaid Application Mistakes: Errors to Avoid During the Application Process

The Medicaid application process can be complicated. However, there are several common mistakes made by filers that can make things even more difficult than they need to be, adding unnecessary obstacles. In this article, we...more

Troutman Pepper Locke

Connecticut Dentists Bite Off More Than They Can Chew; Settle False Claims Allegations for Nearly $500,000

Troutman Pepper Locke on

On May 9, Connecticut Attorney General (AG) William Tong, in collaboration with the U.S. Attorney’s Office for the District of Connecticut, announced a $495,721 false claims settlement with Advanced Dental Center PC (Advanced...more

Mintz - Health Care Viewpoints

CMS Announces Sweeping Changes to RADV Audits

On May 21, 2025, the Centers for Medicare & Medicaid Services (CMS) announced significant changes in its risk adjustment data validation (RADV) audits. The changes focus on speed, the volume of targeted contracts, and...more

Mitchell, Williams, Selig, Gates & Woodyard,...

2025 Arkansas Insurance Legislation Summary: General

This is the first article in a series of summaries of insurance legislation from the 95th Arkansas General Assembly. The 95th Arkansas General Assembly convened on January 13, 2025, and recessed on April 16, 2025. The...more

Epstein Becker & Green

Eleventh Circuit Addresses Rule 9(b) Heightened Pleading Standard in False Claims Act Case

Epstein Becker & Green on

The U.S. Court of Appeals for the Eleventh Circuit has concluded that a successful False Claims Act (FCA) claim should “allege not just a scheme, but a scheme that actually led to false claims being submitted to the...more

Pullman & Comley - Connecticut Health Law

Head of Connecticut OHS to Resign

Late last week, Governor Lamont announced that the Commissioner of the Office of Health Strategy (OHS), Deidre Gifford, plans to retire from state service in June. No successor was named. ...more

Holland & Knight LLP

Holland & Knight Health Dose: May 6, 2025

Holland & Knight LLP on

Reconciliation markups in the U.S. House of Representatives Committee on Energy and Commerce, as well as the House Committee on Ways and Means, were expected to be held this week but have been postponed until next week at the...more

McDermott Will & Schulte

Food as Medicine: A Deep Dive Into Reimbursement

The topic of “food as medicine” has gained increased attention recently, driven by a growing recognition of the role nutrition plays in preventing and managing chronic diseases. This article provides a high-level overview of...more

Stotler Hayes Group, LLC

Medicaid Application Process: Top Tips for Applying for Medicaid

Applying for Medicaid benefits, particularly long-term care benefits, can be difficult and confusing. Yet, it is a necessary evil for many who rely on Medicaid to ensure that they can afford the room, board, care, and...more

Jones Day

CMS Innovation Center Announces Cost-Saving Restructuring of Value-Based Payment Model Portfolio

Jones Day on

The Center for Medicare and Medicaid Services ("CMS") has announced significant changes to its value-based payment model portfolio projected to save $750 million as part of a shift in the agency's refocused strategy toward...more

Littler

NY Federal Court Issues TRO Against the NY Department of Health

Littler on

As previously reported, in April 2024, New York’s Social Services Law was amended to include a substantial change to the state’s Consumer Directed Personal Assistance Program (CDPA Program), a Medicaid-funded program allowing...more

Smart & Biggar

Government of Canada announces first pharmacare agreements

Smart & Biggar on

Update: The Government of Canada announced an agreement with the Yukon ($9.5 million over four years). The agreement text is available in the updated National pharmacare bilateral agreements resource....more

Stikeman Elliott LLP

British Columbia and Prince Edward Island Sign Pharmacare Agreement with Canada Under New Pharmacare Act

Stikeman Elliott LLP on

On February 27, 2025, the Government of Canada and Manitoba signed the first national pharmacare agreements under Canada’s Bill C-64, An Act respecting pharmacare (the “Pharmacare Act”), which received royal assent on October...more

Polsinelli

Back to Backlog? Polsinelli Shareholders Share Insight on how Terminations of DAB Attorneys and Potential Removal of...

Polsinelli on

As the new administration continues its efforts to contract and streamline the federal government, recent developments at the U.S. Department of Health and Human Services (“HHS”) and the Department of Justice (“DOJ”) hint at...more

32 Results
 / 
View per page
Page: of 2

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide