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Medicaid › Government Agencies

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 -
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

Rivkin Radler LLP

NY Medical Transport Owner Sentenced for Medicaid Fraud

Rivkin Radler LLP on

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

Polsinelli

HCBS Update: Indiana Implements Home-Grown 70/30 Direct Caregiver Compensation Requirement

Polsinelli on

Executive Summary: On July 10, 2025, Indiana Medicaid issued guidance to providers of attendant care and structured family caregiver services requiring providers to pass through a specific percentage of their Medicaid...more

McDermott+

Healthcare Extenders Tracker (July 2025 Update)

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Many healthcare programs are extended for specific time periods, as short as one or two years or as long as 10, and are usually attached to a larger piece of must-pass legislation. Additionally, while traditional...more

Rivkin Radler LLP

DOJ and HHS Announce FCA Working Group

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On July 2, the U.S. Department of Justice (DOJ) and Department of Health and Human Services (HHS) announced the formation of the DOJ-HHS False Claims Act Working Group to strengthen “their ongoing collaboration to advance...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

Brownstein Hyatt Farber Schreck

Final Health Care Provisions in the “One Big Beautiful Bill Act”

Brownstein Hyatt Farber Schreck on

On July 4, President Donald Trump signed into law the Republican budget reconciliation package, also referred to as the One Big Beautiful Bill (OBBB) Act. The legislation enacts sweeping changes to tax, immigration, energy,...more

Harris Beach Murtha PLLC

OMIG Announces 12-Month Review Period for its Compliance Program Reviews

Harris Beach Murtha PLLC on

The New York State Office of the Medicaid Inspector General (“OMIG”) issued a Listserv Notice on June 26, 2025 advising that its Compliance Program Reviews (“CPRs”) beginning after July 1, 2025, will use a 12-month Review...more

Alston & Bird

Health Care Week in Review | Congress Passes One Big Beautiful Bill Act; CMS Releases Proposed Payment Rules for ESRD and Home...

Alston & Bird on

Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

McDermott Will & Emery

This Week in 340B: June 24 – 30, 2025

McDermott Will & Emery on

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

Epstein Becker & Green

HHS OIG Continues to Highlight How Medicaid Fraud Control Units Recovered $1.4 Billion in FY 2024

Epstein Becker & Green on

On June 25, 2025, the Office of the Inspector General (“OIG”) of the U.S. Department of Health and Human Services (“HHS”) released a short video containing the highlights of the Medicaid Fraud Control Units (“MFCUs”) Annual...more

Epstein Becker & Green

Medicaid Fraud Recoveries Top More Than $1 Billion in 2024—But Will the Big Beautiful Bill Impact Those Numbers in 2025?

Epstein Becker & Green on

On June 25, 2025, the Office of the Inspector General (“OIG”) of the U.S. Department of Health and Human Services (“HHS”) released a short video containing the highlights of the Medicaid Fraud Control Units (“MFCUs”) Annual...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

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

Alston & Bird

Health Care Week in Review | Senate Finance Committee Releases Budget Reconciliation Text; SCOTUS Upholds TN Ban on...

Alston & Bird on

Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

McDermott+

McDermott+ Check-Up – June 18, 2025

McDermott+ on

THIS WEEK’S DOSE - - Senate Finance Committee Releases Reconciliation Text. The language is subject to change as negotiations continue and the Byrd rule process plays out. - CMS Releases MA Risk Adjustment Audit Methodology...more

DLA Piper

GAO Report Gives MA Organizations and Behavioral Health Providers Food for Thought on Prior Authorization

DLA Piper on

The US Government Accountability Office (GAO) recently released a report on the Centers for Medicare and Medicaid Services (CMS)’s oversight of prior authorization criteria for behavioral health services (BHS) by Medicare...more

Pietragallo Gordon Alfano Bosick & Raspanti,...

An Emerging Opportunity for the States to Revitalize Their State False Claims Act Enforcement

Pietragallo Gordon Alfano Bosick & Raspanti,... on

While the Trump administration replaces all of the United States Attorneys, as well as many senior-level positions at the Department of Justice, stakeholders will soon be able to evaluate civil enforcement priorities under...more

Brownstein Hyatt Farber Schreck

Most-Favored-Nation Drug Pricing in the U.S.

Brownstein Hyatt Farber Schreck on

On May 12, President Trump issued an Executive Order (EO) on drug pricing: “Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients.” The EO requires a 30-day government negotiation with drug companies...more

Akin Gump Strauss Hauer & Feld LLP

Eliminating Waste, Fraud, and Abuse in Medicaid (Trump EO Tracker)

Akin Gump Strauss Hauer & Feld LLP on

This memorandum directs the Secretary of Health and Human Services to take appropriate action to eliminate waste, fraud, and abuse in Medicaid, including by ensuring Medicaid payments rates are not higher than Medicare....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

Patrick Malone & Associates P.C. | DC Injury...

Better Health Care Newsletter - June 2025

Patrick Malone & Associates P.C. | DC Injury... on

Rain Man. Curious Incident of the Dog in the Night-Time. Temple Grandin. On the spectrum. Neurodivergent. Sound familiar? The likelihood that they do shows how, in a relatively short time, public awareness about autism...more

Cozen O'Connor

Illinois Insights: An update from Cozen O'Connor (6/2)

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Illinois Democrats pass budget in final minutes with sports betting tax hike- “Illinois lawmakers approved a $55.2 billion state budget package minutes ahead of a key constitutional deadline Saturday night, relying on tax...more

McDermott+

CMS Requests Hospitals Submit Gender-Affirming Care Data- (UPDATED)

McDermott+ on

On May 28, 2025, the Centers for Medicare & Medicaid Services (CMS) sent a letter to “select hospitals” that provide gender-affirming care services, requesting information about how those hospitals adhere to quality standards...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

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