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Medicaid › Healthcare Reform › Physicians

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

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

Lathrop GPM

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

Lathrop GPM on

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

Sheppard Mullin Richter & Hampton LLP

Takeaways from the America’s Physician Groups’ Spring Conference: Turbulent Times Call for Change and Innovation

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“Kicking Off Accountable Care” served as the theme for this year’s America’s Physician Groups’ (“APG”) Spring Conference, a three-day event packed with compelling speakers and breakout sessions focused on the state of...more

Holland & Knight LLP

CMMI's New Strategic Direction: What to Know

Holland & Knight LLP on

Following the announcement that four Center for Medicare and Medicaid Innovation (CMMI or Innovation Center) models will end in 2025, the Centers for Medicare & Medicaid Services (CMS) has begun signaling what's next for the...more

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - May 2025 #2

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News Briefs - States, D.C., File Lawsuit to Block Trump's HHS Restructuring - A coalition of 20 attorneys general is suing to block what they say is the Trump administration's "dangerous dismantling" of the federal health...more

Jones Day

CMS Innovation Center Announces Cost-Saving Restructuring of Value-Based Payment Model Portfolio

Jones Day on

The Center for Medicare and Medicaid Services ("CMS") has announced significant changes to its value-based payment model portfolio projected to save $750 million as part of a shift in the agency's refocused strategy toward...more

Spilman Thomas & Battle, PLLC

The Dome Report: Cross Over Day at the 2025 Session of the West Virginia Legislature

Spilman Thomas & Battle, PLLC on

Cross Over Day at the West Virginia Legislature separates the living bills from those that are most likely dead for the session. At the conclusion of the floor sessions on April 2, all bills have to be out of their house of...more

Polsinelli

HCPF Makes Clarifications to Mandatory Facility-Based Professionals’ Reporting Requirements Under Colorado Hospital Discounted...

Polsinelli on

What is Colorado Hospital Discounted Care? Colorado’s Hospital Discounted Care law, effective September 1, 2022, brought a detailed and comprehensive yet highly confounding overhaul to the way hospitals, freestanding...more

Whiteford

Navigating Value-Based Care in Anesthesia: Enhancing Patient Outcomes Amid Legal Complexities

Whiteford on

Value-based care (VBC) is a healthcare delivery model that prioritizes patient outcomes over the volume of services provided. This approach aims to enhance the quality of care while controlling costs by incentivizing...more

Sheppard Mullin Richter & Hampton LLP

Navigating Gainsharing Pitfalls in Value-Based Models

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As the shift toward value-based care continues to transform the healthcare industry, hospitals and health systems are increasingly utilizing incentive-based physician compensation structures. Incentive-based compensation...more

Epstein Becker & Green

CMS Finalizes Medicaid Access Rule: Significant Changes Ahead for HCBS Industry

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On April 22, 2024, the Centers for Medicare & Medicaid Services (CMS) issued Ensuring Access to Medicaid Services, a final rule designed to address a range of barriers that Medicaid beneficiaries face in accessing home- and...more

Epstein Becker & Green

California Finalizes SB 184 Pre-Transaction Notice Requirements for “Material Change” Health Care Transactions

Epstein Becker & Green on

On December 18, 2023, the California Office of Administrative Law approved the emergency regulations promulgated by the Office of Health Care Affordability (OHCA) that set forth the procedural framework for (i) the...more

Epstein Becker & Green

CMS Announces the Making Care Primary Model, a Multistate Initiative to Strengthen Primary Care

Epstein Becker & Green on

On June 8, 2023, the Centers for Medicare & Medicaid Services (CMS), Center for Medicare and Medicaid Innovation (CMMI), announced a new demonstration model under the authority of Section 1115A of the Social Security Act that...more

Shumaker, Loop & Kendrick, LLP

Client Alert: No Surprises Act: Good Faith Estimate Requirements

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The No Surprises Act (NSA) imposes numerous requirements on health care facilities and other providers regarding protections against surprise billings. The requirements include posting and delivering notices regarding the...more

Sands Anderson PC

Fourth Circuit Holds that Federal Rights Cannot Be Waived Ex Ante

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A recent ruling by the United States Court of Appeals for the Fourth Circuit serves as a warning to healthcare providers against entering into service contracts that attempt to avoid being sued under 42 U.S.C. § 1983....more

Epstein Becker & Green

[Webinar] The Future of CMS: A Conversation with Three Former CMS Administrators - July 15th, 12:00 pm - 1:00 pm ET

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Epstein Becker Green invites you to join former CMS Administrators Tom Scully, Leslie Norwalk, and Marilyn Tavenner for a unique panel discussion on their thoughts, advice, and predictions for President Biden’s newly...more

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

To rein in health costs, experts focus on $1.2 trillion in U.S. hospital spending

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

Although politicians have obsessed for a decade about affordable health insurance, frustrated patients have seen little or no relief on another crucial concern — the skyrocketing costs of medical services. What policy paths...more

Epstein Becker & Green

The No Surprises Act: Implications for Health Plans, Health Care Facilities, and Health Care Providers

Epstein Becker & Green on

Following months of congressional negotiations, on December 27, 2020, President Trump signed into law the Consolidated Appropriations Act, 2021, a $2.3 trillion piece of legislation that includes $900 billion in federal...more

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

Hospitals start to roll out newly required data on prices and confidential deals

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

A lot of people in health care across the country are firing up their computers to dig into long-sought, confidential information from hospitals about their prices and deals they cut on them with an array of parties....more

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

U.S. long hoped to reduce health spending. Now it’s happened, but it may not be good.

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

The nation has gotten some long-desired, important health care economic news: The country  has “bent the cost curve,” seeing 2020 as the first year in at least six decades in which America’s health care spending went down....more

Burr & Forman

Proposed Stark Law Changes May Impact Physician Compensation Models

Burr & Forman on

On October 9, 2019, the Centers for Medicare and Medicaid Services (“CMS”) proposed sweeping changes to the federal Physician Self-Referral Law, commonly referred to as the Stark Law. While many of the changes reflect CMS’...more

Akerman LLP - Health Law Rx

2020 Legislative Session –A Sampling of Health Related Bills Filed

Akerman LLP - Health Law Rx on

The 2020 Legislative Session will begin its 60-day trek to completion on Tuesday, January 14, 2020. The following is a sample of bills that have been filed. We encourage you to review these bills, and contact us with specific...more

Bricker Graydon LLP

CMS proposes new Stark Law exception for limited remuneration to a physician

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On October 9, 2019, the Centers for Medicare and Medicare Services (CMS) released proposed changes to the regulations interpreting the Physician Self-Referral Law (Stark Law), including a new proposed exception for limited...more

Sheppard Mullin Richter & Hampton LLP

Global and Professional Options Direct Contracting Model RFA and LOI Now Active

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On April 21, 2019, the Center for Medicare and Medicaid Innovation (“CMMI”) announced the CMS Primary Cares Initiative – a voluntary, risk-based initiative to transform the Medicare program’s reimbursement of primary care...more

Bricker Graydon LLP

CMS proposes to change the way group practices can pay profit shares to physicians under Stark Law

Bricker Graydon LLP on

Part of the Centers for Medicare and Medicaid Services’ (CMS) proposed changes to the regulations interpreting the Physician Self-Referral Law (the “Stark Law”), released on October 9, 2019, include changes to the special...more

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