News & Analysis as of

Healthcare State and Local Government Medicaid

McDermott Will & Emery

This Week in 340B: July 15 – 21, 2025

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Find this week’s updates on 340B litigation to help you stay in the know on how 340B cases are developing across the country. Each week we comb through the dockets of more than 50 340B cases to provide you with a quick...more

McDermott Will & Emery

Trending in Telehealth: June 2025

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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

Quarles & Brady LLP

Accessing Opioid Settlement Funds

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While federal funding for addiction treatment programs and research is being cut, more than $50 billion is being distributed to state and local programs from opioid-related lawsuits. There is great debate on the use of these...more

Rivkin Radler LLP

NY Medical Transport Owner Sentenced for Medicaid Fraud

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The owner of Sublime Medical Transportation in Schenectady County, New York was recently sentenced to three to nine years in state prison for orchestrating a large Medicaid fraud scheme. Muhammed Adnan Saeed netted over...more

Stotler Hayes Group, LLC

Still Stuck in the (Utah) Gap: How the “Miller Trust” Punishes the Most Vulnerable

For those seeking Medicaid coverage to pay for their care in a skilled care setting, like a nursing home, the Medicaid process can be daunting. For institutional Medicaid approval, an applicant must prove that they are...more

Cozen O'Connor

Pennsylvania Perspective for Thursday, July 17, 2025

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PA Budget Bill Passes in House, Stalls in Senate - On Monday, the Democratic-led state House voted to forward their state budget bill to the Senate, where GOP leadership is skeptical of full passage. While the House’s...more

Sheppard Mullin Richter & Hampton LLP

Policy Brief: Aligning Nursing Home Bed Planning with New York’s Certificate of Need Reform Goals

Last month, New York State began a formal review of its Certificate of Need (CON) process for nursing homes, launching a timely conversation about how best to align regulatory oversight with evolving system needs. A new...more

Foley & Lardner LLP

Colorado Medicaid: RAC Program Overhauled with Enhanced Transparency, Greater Provider Protections, and Increased Oversight

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In June 2025, Colorado passed a new law that makes significant changes to the state’s Medicaid Recovery Audit Contractor (RAC) program. Colorado has one of the most aggressive RAC programs in the country that has been rife...more

Cozen O'Connor

Pennsylvania Perspective for Thursday, July 10, 2025

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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

King & Spalding

Supreme Court Holds Medicaid Participants Lack Standing to Enforce “Any-Qualified-Provider” Clause

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On June 26, 2025, the Supreme Court ruled that Medicaid providers and beneficiaries lack the ability to enforce the Medicaid Act’s “any‑qualified‑provider” clause in federal court. In Medina v. Planned Parenthood, the Court...more

McDermott Will & Emery

This Week in 340B: June 24 – 30, 2025

Find this week’s updates on 340B litigation to help you stay in the know on how 340B cases are developing across the country. Each week we comb through the dockets of more than 50 340B cases to provide you with a quick...more

Goodwin

Health Headlines: June 2025

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Welcome to the seventh issue of Health Headlines, a newsletter created by lawyers in our Healthcare practice. Iowa Governor Kim Reynolds signed Senate File 383 into law, placing new restrictions on pharmacy benefit...more

ArentFox Schiff

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

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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

ArentFox Schiff

District of Columbia’s FY 2026 Budget Unveils BHP Initiative

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District of Columbia Mayor Muriel Bowser’s FY 2026 Budget introduces a new Basic Health Program (BHP) that will fundamentally reshape health coverage options for thousands of District residents beginning next calendar year....more

Troutman Pepper Locke

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

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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

Bradley Arant Boult Cummings LLP

Alabama CON Report - June 2025

I. Certificate of Need Program - A. AL2024-031, Springhill Hospital, Inc. d/b/a Springhill Medical Center, Mobile County, AL: Proposes to add twenty (20) inpatient rehabilitation beds to an existing eighteen (18) bed...more

Lathrop GPM

Where To, Medicaid? House Legislation Makes Significant Changes; Senate Future is Uncertain

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On May 22, 2025, after a marathon markup session, the U.S. House of Representatives passed a bill containing significant proposed changes to the Medicaid program....more

King & Spalding

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

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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

Sheppard Mullin Richter & Hampton LLP

House-Passed Budget Bill – the One Big Beautiful Bill Act – Includes Major Changes to Medicaid

On Thursday, May 22, 2025, the U.S. House of Representatives narrowly passed the One Big Beautiful Bill Act, a budget reconciliation bill introduced by House Republicans, by a 215-214 vote. The bill extends key provisions of...more

Sheppard Mullin Richter & Hampton LLP

Proposed Rule on Medicaid Tax Waivers: CMS Moves to Close a Loophole Shifting Costs to the Federal Government

On May 15, 2025, the Centers for Medicare & Medicaid Services (“CMS”) released a proposed rule, entitled “Preserving Medicaid Funding for Vulnerable Populations – Closing a Health Care-Related Tax Loophole” to address a...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

King & Spalding

CMS Will Likely Stop Funding Certain State Medicaid Programs

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CMS announced this month that it does not anticipate using federal funds to match state funds for designated state health programs (DSHP) and designated state investment programs (DSIP) under its section 1115 demonstration...more

Sheppard Mullin Richter & Hampton LLP

Recent Legal and Regulatory Developments Involving Gender-Affirming Care

On January 28, 2025, President Trump signed Executive Order 14187 (the “EO”), which directed the federal government to take steps to ensure that the federal government does not “sponsor, promote, assist, or support” the...more

Bass, Berry & Sims PLC

Arkansas Restricts PBM Ownership of Pharmacies and Limits Manufacturers’ Use of Limited Distribution Networks

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On April 16, Arkansas Governor Sarah Huckabee Sanders signed into law HB1150 and HB1531, two significant pieces of legislation affecting pharmacy benefit managers (PBMs) and pharmaceutical manufacturers operating within the...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

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