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Medicaid › State and Local Government › Centers for Medicare & Medicaid Services (CMS)

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 -
Morgan Lewis

‘One Big Beautiful Bill Act’: Key Final Medicaid Changes Explained

Morgan Lewis on

The One Big Beautiful Bill Act was signed into law on July 4 and includes significant changes to the Medicaid program, particularly with regard to state and federal financing for the program. This LawFlash provides a...more

King & Spalding

Senate Finance Committee Releases Budget Bill with More Aggressive Medicaid Provider Changes Than House Version

King & Spalding on

On June 16, 2025, the U.S. Senate Finance Committee released draft legislative language for its version of the “One Big Beautiful Bill Act,” a comprehensive budget reconciliation proposal that includes significant changes to...more

ArentFox Schiff

District of Columbia’s FY 2026 Budget Unveils BHP Initiative

ArentFox Schiff on

District of Columbia Mayor Muriel Bowser’s FY 2026 Budget introduces a new Basic Health Program (BHP) that will fundamentally reshape health coverage options for thousands of District residents beginning next calendar year....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

King & Spalding

CMS Announces Heightened Financial Oversight to Detect Misuse of Medicaid Funds Used for Immigrant Care

King & Spalding on

CMS announced in a letter released on Tuesday, May 27, 2025 (CMS Letter) that it will ramp up financial oversight of states to detect misuse of federal Medicaid funds “[t]o ensure that federal money is not used to pay for or...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

King & Spalding

Budget Reconciliation Bill Impacts Medicaid Financing, Programs, and Eligibility

King & Spalding on

Last week, the House Energy & Commerce Committee marked up legislation that would significantly affect the Medicaid program, including changes to state Medicaid financing mechanisms, state directed payment programs that...more

Sheppard Mullin Richter & Hampton LLP

House-Passed Budget Bill – the One Big Beautiful Bill Act – Includes Major Changes to Medicaid

Sheppard Mullin Richter & Hampton LLP on

On Thursday, May 22, 2025, the U.S. House of Representatives narrowly passed the One Big Beautiful Bill Act, a budget reconciliation bill introduced by House Republicans, by a 215-214 vote. The bill extends key provisions of...more

Sheppard Mullin Richter & Hampton LLP

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

Sheppard Mullin Richter & Hampton LLP on

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

Stotler Hayes Group, LLC

Common Medicaid Application Mistakes: Errors to Avoid During the Application Process

Stotler Hayes Group, LLC on

The Medicaid application process can be complicated. However, there are several common mistakes made by filers that can make things even more difficult than they need to be, adding unnecessary obstacles. In this article, we...more

King & Spalding

CMS Will Likely Stop Funding Certain State Medicaid Programs

King & Spalding on

CMS announced this month that it does not anticipate using federal funds to match state funds for designated state health programs (DSHP) and designated state investment programs (DSIP) under its section 1115 demonstration...more

Cozen O'Connor

Democratic AGs Mount Fevered Challenge to Proposed Rule Impacting Affordable Care Act

Cozen O'Connor on

A group of 22 Democratic AGs submitted comments opposing the Centers for Medicare and Medicaid Services’s (CMS) Proposed Rule, which would change enrollment, eligibility, and coverage under the Patient Protection and...more

Sheppard Mullin Richter & Hampton LLP

CMS to Withdraw Federal Medicaid Match for Workforce, Social Needs, and Infrastructure: What States, Health Care Providers and...

Sheppard Mullin Richter & Hampton LLP on

In a move signaling a major shift in federal priorities, the Centers for Medicare & Medicaid Services (“CMS”) recently announced it will limit federal funding for state Medicaid initiatives that support services beyond direct...more

Epstein Becker & Green

CMS Tells States “No More” Medicaid Section 1115 Matching Funds for Designated State Health Programs (DSHP) and Designated State...

Epstein Becker & Green on

In recent years, the Centers for Medicare & Medicaid Services (CMS) has approved demonstrations under Section 1115 of the Social Security Act, providing federal matching funds for state expenditures for Designated State...more

Littler

DOJ Files a Statement of Interest in a Federal Lawsuit Against the NY Department of Health and Court Issues a Preliminary...

Littler on

As previously discussed, in Engesser v. McDonald, a class of Medicaid beneficiaries who receive personal care and home care services through New York’s CDPA Program (Consumers), and two independent living centers...more

Sheppard Mullin Richter & Hampton LLP

Medicaid in the Crosshairs What Restructuring Could Mean for States, Providers, and Beneficiaries

Sheppard Mullin Richter & Hampton LLP on

As budget negotiations heat up in Washington, Medicaid has emerged as a key target for cost-cutting measures. With policymakers looking to trim federal spending while maintaining commitments to Social Security and Medicare,...more

McDermott Will & Schulte

New York Executive Budget Proposes Amendments to MCO Provider Tax

McDermott Will & Schulte on

The New York State Executive Budget for Fiscal Year (FY) 2026 proposes significant updates to the managed care organization (MCO) provider tax, aiming to enhance Medicaid funding through innovative financial strategies. The...more

Falcon Rappaport & Berkman LLP

Disruptions to the Medicaid System, Alongside Trump Administration’s Freeze of Federal Funding to Agencies, Results in Lawsuit by...

Falcon Rappaport & Berkman LLP on

On the evening of January 27, 2025, the Trump Administration’s Office of Management and Budget (OMB) issued a “Memorandum for Heads of Executive Departments and Agencies” titled, “Temporary Pause of Agency Grant, Loan, and...more

McDermott Will & Schulte

New York State Budget Institutes Revenue-Neutral Health Plan Tax

McDermott Will & Schulte on

The New York State fiscal year 2024 – 2025 budget was signed on April 20, 2024, instituting, among many other provisions, a new tax on health plans, including insurers and managed care organizations. This tax has been...more

McDermott+

Policy Update - New York 1115 Waiver Amendment Timeline for Medicaid Hospital Global Budget Initiative

McDermott+ on

A key element of the Medicaid Redesign Team 1115 Waiver amendment is the Medicaid Hospital Global Budget Initiative (GBI), a reimbursement model tied very closely to the States Advancing All-Payer Health Equity Approaches and...more

Foley Hoag LLP - Medicaid and the Law

Oregon’s New Waiver Request to Exclude Accelerated Approval Drugs from Medicaid Coverage

Foley Hoag LLP - Medicaid and the Law on

Hello readers! Today’s post focuses on a topic we’ve touched on a few times in the past – Medicaid drug formularies. Back in December 2021, the state of Oregon released a draft Medicaid waiver proposal that caught the...more

Foley Hoag LLP - Medicaid and the Law

Georgia Files Suit Against CMS for “Regulatory Bait and Switch” Over its Expansion Population

Foley Hoag LLP - Medicaid and the Law on

On January 22, 2022, Georgia and the Georgia Department of Community Health filed suit against the Centers for Medicare & Medicaid Services (CMS) seeking to prevent the rescission of the central aspects of Georgia’s 1115...more

Kerr Russell

Telemedicine in Michigan: 2021

Kerr Russell on

The COVID-19 pandemic continues to demonstrate the importance and effectiveness of telemedicine as a means of providing patients with access to safe and quality medical care through the use of technology... Originally...more

Foley Hoag LLP - Medicaid and the Law

BREAKING: CMS Withdraws Letter of Agreements to States Establishing Additional Procedures for Waiver Withdrawals

Foley Hoag LLP - Medicaid and the Law on

This just in – as previously discussed, on January 4, 2021 CMS Administrator Seema Verma sent a letter (available here) to State Medicaid Directors requesting they sign a Letter of Agreement “as soon as possible” establishing...more

King & Spalding

Trump Administration Approves Georgia’s Limited Expansion of Medicaid and Work Requiremen

King & Spalding on

CMS approved Georgia’s Section 1115 demonstration project to partially expand Medicaid coverage for adults not otherwise eligible for Medicaid coverage with incomes up to 95 percent of the Federal Poverty Line (FPL)—short of...more

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