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Medicaid › Managed Care Contracts › 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 -
Sheppard Mullin Richter & Hampton LLP

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

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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

Smith Anderson

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

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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

Greenbaum, Rowe, Smith & Davis LLP

The CMS Managed Care Final Rule: Access Standards, Consumer Surveys, Payment Standards and More for Managed Medicaid and CHIP

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Greenbaum healthcare attorneys Neil M. Sullivan and Jennifer A. Belardo analyze the CMS’s Medicaid and Children’s Health Insurance Program (CHIP) Managed Care final rule – and its impact on states, healthcare providers, and...more

Hogan Lovells

CMS finalizes new standards and reporting obligations affecting Medicaid and CHIP managed care plans

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On April 22, 2024, the Centers for Medicare & Medicaid Services (CMS) published the Medicaid and Children's Health Insurance Program (CHIP) Managed Care Access, Finance, and Quality Final Rule and the Ensuring Access to...more

McDermott+

CMS Finalizes Major Reforms to Medicaid, Part 2: Medicaid Managed Care Reg

McDermott+ on

Medicaid Regs Part 2! Last week, Regs & Eggs took a deep dive into the Ensuring Access to Medicaid Services final reg, one of two regs that the Centers for Medicare & Medicaid Services (CMS) released to add new requirements...more

Rivkin Radler LLP

[Webinar] Healthcare Compliance Lunch & Learn Series: Defending Provider Audits - April 11th, 12:00 pm - 1:00 pm ET

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On Thursday, April 11, the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, will be presented by Rivkin Radler attorneys, Bob Hussar, Chris Kutner and Mary Aperance. The program, “Defending...more

American Conference Institute (ACI)

[Event] 15th Annual Advanced Forum on Managed Care Disputes and Litigation - May 2nd - 3rd, Chicago, IL

American Conference Institute (ACI) on

ACI’s Advanced Forum on Managed Care Disputes and Litigation offers an unparalleled learning experience, specifically designed for the MCO legal community. Attend and develop winning legal strategies and business best...more

Foley Hoag LLP

CMS Releases Request for Information on Medicare Advantage Data

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On January 30, 2024, CMS published in the Federal Register an RFI to seek input from the public regarding increased public releases of MA data to improve transparency in the program. CMS stated responses to this RFI may be...more

McDermott+

Looking Forward: Top Policy Areas for 2024

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Happy New Year! As we enter 2024, we want to lay out some of the main regulatory issues (both new and old) that McDermott+Consulting will be tracking over the next year. While these may evolve, we think they are still...more

Nossaman LLP

Managed Care Plans Take Note: OIG’s Managed Care Strategic Plan

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With the tremendous growth of managed care over the last several years, the Medicare and Medicaid programs have had to transform how they fund health care for approximately 100 million enrollees. According to the Department...more

Littler

New York Department of Health Sets New Due Dates for Submission of Home Care Worker Wage Parity Compliance Certifications and...

Littler on

On September 21, 2023, the New York Department of Health (DOH) issued guidance addressing the due dates for Medicaid Managed Care Organizations (MMCOs), Certified Home Health Agencies (CHHAs), Licensed Home Care Services...more

Health Care Compliance Association (HCCA)

[Event] 2024 Managed Care Compliance Conference - January 29th - 30th, Coronado, CA

Health Care Compliance Association (HCCA) on

Explore the unique issues that are pertinent to managed care professionals! This annual event dedicated to compliance management for health plan providers is returning to an in-person format for 2024. Join your peers and...more

Holland & Knight LLP

Holland & Knight Health Dose: July 25, 2023

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Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector. ...more

Nossaman LLP

CMS Attempts to Reduce Appointment Times for Medicaid and CHIP Patients - How Will This Impact Your Managed Care Plan?

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A recent survey found that the average wait time for a new patient to see a physician in 15 of the largest cities in the U.S. was 26 days, up from 24.1 days in 2017.  Timely access to health care providers has long been an...more

Burr & Forman

Hot Topics in Health Care May 2023

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Proposed Protections for Patient Data Related to Reproductive Care - On April 12, 2023, the Office for Civil Rights (OCR) at the U.S. Department of Health & Human Services (HHS) proposed a new rule to strengthen HIPAA...more

Sheppard Mullin Richter & Hampton LLP

Attention New York Medicaid Providers: It’s Time to Upgrade Your Compliance Program

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On January 31, 2023, the New York State Office of the Medicaid Inspector General (OMIG) released three guidance documents to assist Medicaid providers in meeting the requirements of recently adopted regulations governing (i)...more

Rivkin Radler LLP

[Webinar] Lunch and Learn Series: OMIG's FINALIZED Regulations: What You Need to Do - NOW! - February 9th, 12:00 pm - 1:00 pm ET

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Please join us on February 9 as Partner Bob Hussar and Associates Ashley Algazi and Mary Connolly present on OMIG’s finalized regulations. On December 28th, the Office of Medicaid Inspector General (OMIG) released their...more

Health Care Compliance Association (HCCA)

[Virtual Event] 2023 Managed Care Compliance Conference - January 31st - February 2nd, 8:25 am - 3:15 pm CT

Health Care Compliance Association (HCCA) on

Join us for our annual event dedicated to compliance management for health plan providers. Learn the latest best practices and emerging trends from industry leaders while making connections with peers and mentors who...more

Health Care Compliance Association (HCCA)

[Virtual Event] Healthcare Enforcement Compliance Conference - November 7th - 9th, 8:55 am - 3:30 pm CST

Health Care Compliance Association (HCCA) on

Hear directly from the enforcement community - Want to gain insight into properly monitoring, detecting, investigating, and managing violations? Join us virtually at HCCA’s Annual Healthcare Enforcement Compliance...more

Rivkin Radler LLP

[Webinar] Lunch & Learn Series: New OMIG Compliance Regulations: What You Need to Know - July 28th, 12:00 pm - 1:00 pm ET

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On July 13, the Office of Medicaid Inspector General (OMIG) published proposed regulations implementing 2020 changes to law relating to provider compliance programs, Medicaid managed care fraud, waste and abuse prevention...more

Rivkin Radler LLP

[Webinar] Lunch & Learn Series: New OMIG Compliance Regulations: What You Need to Know - July 27th, 12:00 pm - 1:00 pm ET

Rivkin Radler LLP on

On July 13, the Office of Medicaid Inspector General (OMIG) published proposed regulations implementing 2020 changes to law relating to provider compliance programs, Medicaid managed care fraud, waste and abuse prevention...more

Holland & Knight LLP

Healthcare Law Update: October 2021

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Kathryn Isted In Harbor Healthcare System, L.P. v. United States, 5 F.4th 593 (5th Cir. 2021), the court of appeals ruled that the district court abused its discretion in refusing to exercise its equitable jurisdiction over a...more

Health Care Compliance Association (HCCA)

[Event] 2022 Managed Care Compliance Conference - January 30th - February 1st, Phoenix, AZ

Health Care Compliance Association (HCCA) on

Attend our annual event for those who manage compliance at health plan providers. Explore topics and issues that are pertinent to industry professionals like you. Learn the latest practices, share strategies, and connect with...more

Health Care Compliance Association (HCCA)

[Virtual Event] 2021 Managed Care Compliance Conference - February 1st - 3rd, 9:30 am - 3:45 pm CST

Health Care Compliance Association (HCCA) on

The first ever VIRTUAL Managed Care Compliance Conference will have the great speakers and content you have come to expect from the in-person event. Each year, we look forward to hosting compliance professionals at our...more

Proskauer Rose LLP

New York State Budget Bill Amends Various Medicaid Requirements, Including Compliance Program Requirements Applicable to Health...

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New York State has enacted amendments to provisions of the Social Services Law governing the compliance program requirements applicable to Medicaid providers. These changes generally took immediate effect on April 1, 2020,...more

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