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Medicaid › Health Care Providers

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 -
Oberheiden P.C.

Pharmacy Claim Reversals: Mitigating Risk Before, During, and After an Investigation

Oberheiden P.C. on

Pharmacy claim reversals can be costly. Not only can they have an immediate impact on pharmacies’ cash flow; but, in many cases, they can lead to additional consequences as well. Pharmacies accused of improperly billing...more

Alston & Bird

Health Care Week in Review | CMS Announces Oversight Initiative to Increase Medicaid and CHIP Citizenship Enforcement; HHS...

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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

Husch Blackwell LLP

Colorado Senate Bill 25-276: New Protections and Requirements for Healthcare Providers Regarding Immigration Status and Data...

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The Colorado General Assembly has enacted Senate Bill 25-276 (“SB 25-276” or “Bill”), establishing significant new requirements for healthcare facilities operated by political subdivisions, Public Health-Care Facilities, and...more

Alston & Bird

Health Care Week in Review | Draft MAHA Commission Strategy Document Circulated; President Trump Signs EO Aiming to Fill Drug...

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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

Fisher Phillips

How Will Non-Profits Be Impacted by the Big Beautiful Bill? Your Guide to Key Changes Affecting Charitable Giving, Excise Taxes,...

Fisher Phillips on

President Donald Trump signed a massive budget bill last month – the “One Big Beautiful Bill Act” (OBBBA) – and it significantly impacts non-profits and tax-exempt organizations. While some of the new changes may be...more

Alston & Bird

Health Care Week in Review | HHS Cancels mRNA Vaccine Development Projects Under BARDA; President Trump Signs EO to Increase...

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

Husch Blackwell LLP

DOJ Announces Largest-Ever National Healthcare Fraud Takedown and Launches New Data Fusion Center

Husch Blackwell LLP on

In June 2025, the Department of Justice (DOJ) announced its 2025 National Health Care Fraud Takedown, marking the largest coordinated healthcare fraud enforcement action in DOJ history. The sweep included charges against a...more

McNees Wallace & Nurick LLC

Navigating Pa.’s unique IBHS licensing requirement for ABA therapy providers

McNees Wallace & Nurick LLC on

Per Autism Speaks’ “Autism by the Numbers: 2025 Annual Report” (see autismspeaks.org/ABN, last visited July 20, 2025), currently one in 35 children in the United States has autism....more

Shipman & Goodwin LLP

340B Drug Pricing Program Is on a Slippery Slope

Shipman & Goodwin LLP on

On July 31, 2025, notice was published in the Federal Register by the Health Resources and Services Administration (“HRSA”) of a “340B Rebate Model Pilot Program” (“340B Pilot Program”). The 340B Pilot Program’s stated...more

Sheppard Mullin Richter & Hampton LLP

State-Directed Payments, Value-Based Care, and the “One Big Beautiful” Bill: A Comprehensive Analysis

Sheppard Mullin Richter & Hampton LLP on

Among the many sweeping changes to the Medicaid program included in the One Big Beautiful Bill Act (“OBBBA”), Congress established new statutory caps on state-directed payments (“SDPs”) in Medicaid managed care. SDPs have...more

Troutman Pepper Locke

State AGs Join $202M Settlement Over HIV Drug Kickback

Troutman Pepper Locke on

On July 16, 49 attorneys general (AGs) announced that they joined a $202 million settlement with Gilead Sciences, Inc. (Gilead). Previously announced by the Department of Justice in April, the settlement resolved allegations...more

Alston & Bird

Health Care Week in Review | CMS Finalizes FY 2026 Medicare Payment Rules, Senate Appropriations Committee Advances Labor-HHS...

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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

Rivkin Radler LLP

Expert Witness Report in FCA Case Afflicted with AI Hallucinations

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The epidemic of out-of-control generative artificial intelligence in litigation filings has metastasized to a False Claims Act (FCA) lawsuit against a group of Utah anesthesiologists. On July 25, Mountain West Anesthesia, LLC...more

Sheppard Mullin Richter & Hampton LLP

Potential False Claims Act Liability for Providers of Gender-Affirming Care for Minors

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On July 9, 2025, the U.S. Department of Justice (“DOJ”) announced it sent more than 20 subpoenas to physicians and clinics involved in providing gender-affirming care to minors, and that the subpoenas related to...more

Holland & Knight LLP

Holland & Knight Health Dose: July 29, 2025

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This week, the U.S. House of Representatives will be out of session, as the chamber has adjourned for the August 2025 district work period. The U.S. Senate remains in session and continues to consider nominations to lead...more

Smith Anderson

OBBB Act Brings Major Medicaid Changes: What North Carolina Providers Need to Know

Smith Anderson on

The One Big Beautiful Bill Act (P.L.119-21) (the “OBBB”) passed by slim margins in the U.S. Senate (51-50) and U.S. House (218-214) and was signed into law by President Trump on July 4, 2025....more

McDermott Will & Schulte

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

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - July 2025 #2

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News Briefs - Tariffs May Impact Hospice Mergers and Acquisitions Activity - Tariffs being implemented by the Trump administration could have a dampening effect on an already slumping hospice mergers and acquisitions market....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

Williams Mullen

U.S. Justice Department Renews Enforcement Focus on Health Care Fraud

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In recent weeks, the Justice Department has issued new charging guidelines and announced enforcement actions that reflect the priorities of the current administration. Targeting perceived health care fraud, particularly...more

Brownstein Hyatt Farber Schreck

Understanding the Rural Health Transformation Program

Brownstein Hyatt Farber Schreck on

On July 4, President Donald Trump signed into law H.R. 1, commonly known as the “One Big Beautiful Bill,” or OBBB. The bill is a sweeping package that includes an estimated $1 trillion in cuts to Medicaid. These cuts include...more

Alston & Bird

Health Care Week in Review | Congress Passes Recissions Package, CMS Releases CY 2026 PFS and OPPS Proposed Rules

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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

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

Foley & Lardner LLP

One Big Beautiful Bill: Slashed Budgets Will Disrupt the Medicaid Program

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The new federal budget law, the One Big Beautiful Bill Act (the Act), enacted on July 4, 2025, makes dramatic changes to the Medicaid program. Health care providers, plans, patients, and other stakeholders that work with...more

Sheppard Mullin Richter & Hampton LLP

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

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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

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