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Medicaid Regulatory Reform

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+

McDermott+ Check-Up – July 25, 2025

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CBO releases final scores for OBBBA. The Congressional Budget Office (CBO) estimates that the One Big Beautiful Bill Act (OBBBA) will increase the uninsurance rate by 10 million individuals over 10 years. House Energy and...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

Sheppard Mullin Richter & Hampton LLP

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

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

Foley & Lardner LLP

Colorado Medicaid: RAC Program Overhauled with Enhanced Transparency, Greater Provider Protections, and Increased Oversight

Foley & Lardner LLP on

In June 2025, Colorado passed a new law that makes significant changes to the state’s Medicaid Recovery Audit Contractor (RAC) program. Colorado has one of the most aggressive RAC programs in the country that has been rife...more

Ballard Spahr LLP

The OBBBA’s Impact on Employee Benefits and Executive Compensation

Ballard Spahr LLP on

H.R.1—the One Big Beautiful Bill Act (OBBBA)—contains several provisions that directly affect employer-provided benefit programs, primarily health and welfare programs....more

Goodwin

A Look Ahead in Life Sciences: What We Are Tracking in the Third Quarter of 2025 and Beyond

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As the life sciences, medtech, and diagnostic industries continue to grow increasingly complex, so does the legal, regulatory, and compliance landscape. To help companies and investors navigate the many evolving and emerging...more

Katten Muchin Rosenman LLP

The Joint Commission’s 2025 Accreditation Overhaul: What Healthcare Organizations Need to Know

On June 30, the Joint Commission announced it is transforming its accreditation process, promising a more streamlined, relevant, and supportive process for hospitals and healthcare organizations. One of the most significant...more

Sheppard Mullin Richter & Hampton LLP

New York’s Master Plan for Aging: What Legal, Health, and Policy Leaders Need to Know

On June 30, 2025, New York State released its long-anticipated Master Plan for Aging (MPA), a 10-year strategic framework designed to improve the way the state supports older adults, individuals with disabilities, and family...more

Sheppard Mullin Richter & Hampton LLP

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

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

Cozen O'Connor

Cozen Currents: Are Trump and MAGA One in The Same?

Cozen O'Connor on

“Famously the author of “The Art of the Deal,” President Donald Trump considers himself more of a dealmaker than an ideologue. He sees the world as zero sum and aims to gain maximum leverage. As a result, he’s not as wedded...more

Sheppard Mullin Richter & Hampton LLP

Understanding the Federal Reconciliation Bill’s Implications for MCO Tax Structure

New York’s Medicaid financing strategy—particularly its use of a managed care organization (MCO) tax—has come under renewed federal scrutiny amid recent legislative proposals and regulatory developments. The federal...more

McDermott+

Healthcare Preview for the Week of: June 16, 2025

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The House is out this week for the Juneteenth holiday, but the Senate will be in town through Wednesday. We expect these three days to be significant because the Senate Finance Committee has announced that it intends to...more

Alston & Bird

Look Ahead to the Week of June 16, 2025: Short Week for Senate Ahead of Juneteenth

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The Senate is in session through Wednesday, while the House is out for the week in anticipation of the Juneteenth holiday. Senate Republicans continue to work on revising the House-passed reconciliation package (H.R. 1)....more

Akin Gump Strauss Hauer & Feld LLP

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

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

Jones Day

Medicare's Innovation Center Charts New Direction: Part 1 - Providers

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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

Epstein Becker & Green

CMS Proposes to Close Perceived Loophole in Medicaid Health Care-Related Tax Regulations

Epstein Becker & Green on

On May 12, 2025, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would impose an additional requirement to federal Medicaid regulations in order for non-broad-based and uniform health...more

Sheppard Mullin Richter & Hampton LLP

Proposed Rule on Medicaid Tax Waivers: CMS Moves to Close a Loophole Shifting Costs to the Federal Government

On May 15, 2025, the Centers for Medicare & Medicaid Services (“CMS”) released a proposed rule, entitled “Preserving Medicaid Funding for Vulnerable Populations – Closing a Health Care-Related Tax Loophole” to address a...more

Mintz - Health Care Viewpoints

PBM Legislation in the Reconciliation Bill is Far From Sweeping PBM Reform

Over the past few years, Congress has attempted to pass “federal PBM reform.” Members of Congress have held numerous hearings related to PBMs and introduced numerous bills seeking to regulate PBMs (we regularly track these...more

Sheppard Mullin Richter & Hampton LLP

CMS Administrator Outlines His Vision for CMS at NFP Healthcare Investors Conference

The Administrator for the Centers for Medicare & Medicaid Services (CMS), Dr. Mehmet Oz, spoke to non-profit health system executives, investors, and industry observers this week at the 25th Annual Not-for-Profit Healthcare...more

McDermott+

A Preview of the Preview: Our CY 2026 PFS Proposed Rule Webinar Is Next Wednesday

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It’s getting hot outside, which means that the summer regulatory season is almost upon us. In June or July, the Centers for Medicare & Medicaid Services (CMS) will release proposed regs impacting Medicare payments in...more

Fenwick & West LLP

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

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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

McGuireWoods Consulting

Summary of the House Energy and Commerce Committee’s Reconciliation Provisions on Energy, Environment, Communications and Health

On Tuesday, May 13, 2025, the House Energy and Commerce Committee started their 26-hour consideration of their portion of the budget reconciliation bill. The House Energy and Commerce Committee budget reconciliation...more

Baker Donelson

Proposed Rule for Nursing Homes: Key Updates for FY 2026

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I. Introduction - The Centers for Medicare & Medicaid Services (CMS) issued the proposed rule on April 11, 2025, for the skilled nursing facility (SNF) prospective payment system (PPS) fiscal year (FY) 2026 update (the...more

Bass, Berry & Sims PLC

CMMI Announces New Strategy

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After months of signaling that a new strategy was in the works, on May 13, 2025, the Centers for Medicare & Medicaid Services (CMS) released a new strategic direction for the CMS Center for Medicare and Medicaid Innovation...more

McDermott+

The Missing Puzzle Pieces of the FY 2026 “Skinny” President’s Budget

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Last week, the White House Office of Management and Budget (OMB) released its fiscal year (FY) 2026 discretionary funding request to Congress on its President’s Budget webpage. The administration released a “skinny” FY 2026...more

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