News & Analysis as of

Health Insurance › Patient Access › Medicaid

Quarles & Brady LLP

Manufacturer Rebate Models: The Next 340B Program Battleground

Quarles & Brady LLP on

The 340B Drug Pricing Program (“340B Program”) space continues to be a hive of activity. While 340B stakeholders continue to litigate ongoing manufacturer contract pharmacy restrictions, states legislatures are enacting...more

Troutman Pepper Locke

U.S. Supreme Court Holds Medicaid’s Any-Qualified-Provider Provision Does Not Confer Enforceable Rights

Troutman Pepper Locke on

The U.S. Supreme Court, in a 6-3 decision, ruled that the Medicaid Act’s any-qualified-provider provision does not confer individual rights enforceable under 42 U.S.C. §1983. This decision reverses the Fourth Circuit’s...more

Bass, Berry & Sims PLC

OIG Approves Proposal that Expands Patient Access to Covered Telehealth Services

Bass, Berry & Sims PLC on

On June 11, the U.S. Department of Health and Human Services Office of Inspector General (OIG) published Advisory Opinion 25-03, approving a proposal by a management services organization (MSO) and its friendly PC...more

Jones Day

Medicare's Innovation Center Charts New Direction: Part 3 – Drugs, Devices, and Data

Jones Day on

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

Pullman & Comley, LLC

Is a Civil Rights Lawsuit by Private Parties a Means to Enforce a Federal Free Choice of Medicaid Provider Provision? A Spending...

Pullman & Comley, LLC on

CASE AT A GLANCE - In 2018, Planned Parenthood South Atlantic (PPSAT) and one of its patients, Julie Edwards, sued the administrator of South Carolina’s Medicaid program to enforce the “free choice of Medicaid provider”...more

Seyfarth Shaw LLP

Executive Order on Health Care Access for Gender-Affirming Treatments for Minors

Seyfarth Shaw LLP on

Following through on a campaign theme focused on transgender issues and access to gender-affirming health care, on Friday, January 28, President Trump signed an Executive Order, titled “Protecting Children from Chemical and...more

Sheppard Mullin Richter & Hampton LLP

Continuity in Coverage: CMS Extends the Unwinding SEP & Issues Final Rule for Medicaid and CHIP Enrollment

Sheppard Mullin Richter & Hampton LLP on

On March 28, 2024, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced that it is extending the temporary special enrollment period (the Unwinding SEP)...more

Stotler Hayes Group, LLC

The Great Unwinding And Its Effect On Skilled Nursing Facilities

Stotler Hayes Group, LLC on

Following the termination of the Public Health Emergency (“PHE”) as a result of COVID-19, and the continuous enrollment provisions put in place to ensure that Medicaid beneficiaries were able to receive Medicaid benefits...more

Whiteford

New CMS Guidance on Use of Algorithms and AI in Prior Authorizations and Utilization Management

Whiteford on

Use of algorithms and artificial intelligence (AI) in prior authorization and utilization management is facing growing criticism and litigation. Notable lawsuits include alleged automatic authorization denials for tests that...more

Mintz - Health Care Viewpoints

New Mexico Latest State to Expand Medicaid Behavioral Health Program, Add Mobile Crisis Intervention Program

Mintz - Health Care Viewpoints on

New Mexico recently became the latest state to receive Centers for Medicare & Medicaid Services (CMS) approval to expand the state’s behavioral health service offerings through mobile crisis intervention teams. Under...more

Nossaman LLP

CMS Attempts to Reduce Appointment Times for Medicaid and CHIP Patients - How Will This Impact Your Managed Care Plan?

Nossaman LLP on

A recent survey found that the average wait time for a new patient to see a physician in 15 of the largest cities in the U.S. was 26 days, up from 24.1 days in 2017.  Timely access to health care providers has long been an...more

Bodman

The Expiration of the COVID-19 Public Health Emergency: Part II – Impact on the Provision of Medical Services via Telehealth

Bodman on

As announced by the White House on January 30, 2023, the public health emergency (PHE) is set to end on May 11, 2023. The end of the PHE also brings an end to several flexibilities that were implemented that impact telehealth...more

Burr & Forman

Hot Topics in Health Care – September 2022

Burr & Forman on

Physicians and Pharmacists Concerned Over Post Dobbs State Laws Limiting Independent Medical Judgment - On September 8, 2022, the American Medical Association (AMA), American Pharmacists Association (APhA), American...more

Pullman & Comley - Connecticut Health Law

Health Care Providers Should Take Note of Recent Repeals and Extensions of COVID-Related Executive Orders

Pullman & Comley - Connecticut Health Law on

Governor Lamont’s recent renewal of his declaration of the public health and civil preparedness emergencies through July 20, 2021 was followed by  Executive Order 12B that repeals portions of previously-issued Executive...more

Morgan Lewis

President Biden Expands Access to Affordable Care Act Exchange Plans, Women’s Reproductive Health

Morgan Lewis on

January 28 was designated as “health day” for President Joe Biden’s early push of executive orders, with two new executive actions added to a growing list. The Executive Order on Strengthening Medicaid and the Affordable Care...more

15 Results
 / 
View per page
Page: of 1

"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:
Sign up Log in
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide