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Medicaid › Beneficiaries › Medicare

Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with... more +
Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with children.  less -
Sheppard Mullin Richter & Hampton LLP

Congressional Budget Proposal Includes Adjustments to Dual-Eligible Enrollment Pathways and Medicare Savings Program Rules

Sheppard Mullin Richter & Hampton LLP on

In June 2025, the U.S. House of Representatives introduced a budget reconciliation bill titled the One Big Beautiful Bill Act (OBBBA). The legislation proposes a number of administrative changes to existing federal health...more

Fenwick & West LLP

CMS Seeks Public Input to Modernize the Digital Health Ecosystem for Medicare Beneficiaries

Fenwick & West LLP on

The Centers for Medicare & Medicaid Services (CMS) has issued a new Request for Information (RFI) aimed at transforming how digital health tools serve Medicare beneficiaries....more

Mintz - Health Care Viewpoints

Mintz IRA Update — The First Anniversary of the Inflation Reduction Act: A Year in Review

Mintz - Health Care Viewpoints on

August 16, 2023 marked the one-year anniversary of the enactment of the Inflation Reduction Act (“IRA”). The first 365 days since the IRA’s passage brought the implementation of a number of significant changes to the Medicare...more

White and Williams LLP

Are Syndicated Loans Securities?

White and Williams LLP on

The ongoing case of Kirschner v. JP Morgan Chase Bank, N.A., which has traveled through the New York federal court system since 2018, is now before the Second Circuit, who are tasked with deciding the following: are...more

King & Spalding

CMS Changes Trump-era Innovation Models Affecting ACOS

King & Spalding on

On February 24, 2022, CMS announced major changes to several of its innovation models, including the permanent cancellation of the Geographic Direct Contracting Model—a Trump-era model that tested whether a geographic-based...more

Roetzel & Andress

CMS’s Updated Advance Beneficiary Notice Of Noncoverage (ABN) Is In Effect

Roetzel & Andress on

As of January 1, 2021, providers must use the updated instructions and form Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131. The changes address beneficiaries who are dually enrolled in Medicare and Medicaid...more

Chambliss, Bahner & Stophel, P.C.

Proposed New Medicare Payment System May Affect Beneficiaries

Chambliss, Bahner & Stophel, P.C. on

Medicare is proposing a new flat rate reimbursement system for doctors who treat Medicare patients. Some worry that the plan may reduce payments to specialists and cause fewer doctors to accept Medicare patients....more

Holland & Knight LLP

Healthcare Law Update: May 2018

Holland & Knight LLP on

Enforcement - OIG Issues Advisory Opinion on Provision of Samples by a Device Distributor - On April 30, 2018, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued a...more

McGuireWoods LLP

OIG Raises ‘Nominal Value’ for Gifts to Medicare and Medicaid Beneficiaries

McGuireWoods LLP on

On Dec. 7, 2016, just in time for the holiday season, the Office of Inspector General (OIG) released a policy statement regarding the nominal value of gifts that healthcare providers may give to Medicare and Medicaid...more

Buchalter

OIG Finalizes New and Expanded Anti-Kickback Safe Harbors, Issues Guidance Regarding Nominal Gifts

Buchalter on

In an uncertain health care environment following the presidential election, the Department of Health & Human Services Office of Inspector General (“OIG”) finalized a new rule expanding existing safe harbors to the federal...more

McDermott Will & Emery

CMS Proposes Value-Based Purchasing Model, Other Updates to the 2016 Home Health Prospective Payment System

McDermott Will & Emery on

The U.S. Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) published its proposed update to the home health prospective payment system (HHPPS) for calendar year (CY) 2016 in the July...more

Arnall Golden Gregory LLP

CMS Proposes to Establish Separate Payment for End of Life Planning Services

Arnall Golden Gregory LLP on

On July 8, 2015, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that updates payment rates and related reimbursement and quality policies for physician services furnished under the Medicare...more

Mintz - Health Care Viewpoints

Delivery System Reform 2.0: Scaling Alternative Payment Models is the New Normal

Mintz - Health Care Viewpoints on

For some health care providers, a pair of recent announcements made by the Obama Administration to implement mandatory alternative payment models (APMs) for home health value-based purchasing and bundled payments for hip and...more

Foley & Lardner LLP

Beneficiary Assignment Under the MSSP Final Rule

Foley & Lardner LLP on

This is the fourth post in Health Care Law Today’s series on the final rule. This post addresses how CMS assigns beneficiaries to an ACO participating in the MSSP. In the MSSP ACO Final Rule, CMS finalized new...more

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