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Medicaid › State Health Departments

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 -
Fennemore

California’s Bold Experiment with Whole-Person Centered Care: Has it Worked?

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CalAIM is an initiative of the California Department of Health Care Services (the Department) to improve the quality of life and health outcomes of Medi-Cal members by implementing delivery system, program, and payment...more

Mintz - Health Care Viewpoints

New York Department of Health Publishes Material Transactions Reporting Form

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In our February 14, 2025 blog post, we detailed a proposed expansion of Article 45-A of New York’s Public Health Law (hereinafter, the Disclosure of Material Transactions Law) included in the proposed Fiscal Year 2026 New...more

Holland & Knight LLP

New York Aims to Restore Choice in CDPAP with Expanded Fiscal Intermediary Licensure

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New York State lawmakers introduced a new bill this past week hoping to reverse recent structural changes to the Consumer Directed Personal Assistance Program (CDPAP) by allowing multiple licensed Fiscal Intermediaries...more

Holland & Knight LLP

Preliminary Injunction Agreement Balances CDPAP Transition and Consumer Care

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Following Judge Frederic Block's March 31, 2025, issuance of a temporary restraining order (TRO) temporarily halting New York state's push to consolidate the Consumer Directed Personal Assistance Program (CDPAP) under a...more

Holland & Knight LLP

Federal Judge Issues TRO Pausing CDPAP Transition

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Judge Frederic Block of the U.S. District Court for the Eastern District of New York issued a temporary restraining order (TRO) on March 31, 2025, stalling the consolidation of the Consumer Directed Personal Assistance...more

Holland & Knight LLP

New York Court Strikes Down CDPAP Reimbursement Changes

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In a significant development for fiscal intermediaries (FIs) and the Consumer Directed Personal Assistance Program (CDPAP), a New York Supreme Court Justice ruled on March 20, 2025, that the New York State Department of...more

Holland & Knight LLP

Judge Issues TRO Pausing Data Transfer Under New CDPAP Framework

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Nassau County Judge Jerome C. Murphy issued a temporary restraining order (TRO) on Jan. 27, 2025, preventing the New York State Department of Health (DOH) from moving forward with the consolidation of the Consumer Directed...more

Shipman & Goodwin LLP

U.S. Supreme Court To Decide Whether Medicaid Recipients Have Right To Choose Provider in Ongoing Court Battle To Restrict Funding...

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The U.S. Supreme Court agreed to hear South Carolina’s challenge to the Fourth Circuit’s decision blocking South Carolina’s Medicaid program from ending its provider agreement with Planned Parenthood. The dispute arises from...more

King & Spalding

Texas Sues Federal Government to Protect Medicaid Financing

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On December 11, 2024, the Texas Health and Human Services Commission filed a complaint in the United States District Court for the Western District of Texas. The complaint seeks to block the enforcement of a May 9, 2014,...more

Holland & Knight LLP

CDPAP Fiscal Intermediary Takes Aim at DOH's Competitive Bidding Process

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Another day, another legal challenge to New York's overhaul of the Consumer Directed Personal Assistance Program (CDPAP). In an emergency petition filed Nov. 25, 2024, by the state's largest fiscal intermediary (FI), Freedom...more

Holland & Knight LLP

Proposed Bill Aims to Resolve CDPAP Controversies and Address Critical Concerns in New York

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A new bill was introduced in the New York State Senate last week in an attempt to address recent changes made to the Consumer Directed Personal Assistance Program (CDPAP), which effective April 1, 2025, will allow only a...more

Holland & Knight LLP

CDPAP Legal Storm Continues: New Lawsuit Targets DOH's RFP Implementation, Single FI Structure

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A second lawsuit has been filed challenging recent changes to New York's Consumer Directed Personal Assistance Program (CDPAP or the Program), this time taking aim at the new single fiscal intermediary (FI) structure that...more

Holland & Knight LLP

Fiscal Intermediaries Sue NYDOH Over CDPAP Reimbursement Changes

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A group of fiscal intermediaries (FIs) on July 22, 2024, filed a lawsuit against the New York State Department of Health (DOH) and its commissioner, Dr. James McDonald, alleging that the defendants disregarded established...more

McCarter & English, LLP

New Jersey Regulatory Update Part II

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Part II of our New Jersey Regulatory Update further identifies proposed and adopted regulations that may impact healthcare providers, from additional financial transparency rules impacting facilities to rules attempting to...more

McCarter & English, LLP

New Jersey Regulatory Update Part I

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It is that time of year for our regulatory update. Parts I and II will discuss proposed and adopted rules from the second half of last year to the first quarter of this year that impact healthcare providers in New Jersey,...more

Harris Beach Murtha PLLC

NYS DOH Seeks Grant Applications for Health Equity Social Care Networks

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The New York Department of Health (DOH) recently announced it is accepting applications for New York Health Equity Reform: Social Care Networks regional grants. The nine regional grants will distribute a total of $500 million...more

Harris Beach Murtha PLLC

New York DOH Revises Medical Respite Program Operator Rules

Harris Beach Murtha PLLC on

The New York Department of Health (DOH) is seeking public comment on its revised rulemaking that seeks to establish procedures for review and approval of applications from not-for-profit corporations to be certified as a...more

Harris Beach Murtha PLLC

Updated Medicaid Utilization Review Regulations from NYS Department of Health

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The New York Department of Health (DOH) adopted regulations effective on September 13, 2023, that revised Medicaid Utilization Review for Medicaid fee-for-service benefits. The regulations were initially published on April...more

Weintraub Tobin

California Medi-Cal Enrollment Appeals: An Uphill Battle but an Essential Tool

Weintraub Tobin on

In our practices, we are seeing an increasing number of denials or de facto denials of Medi-Cal provider enrollments. The consequences of a Medi-Cal enrollment denial can be quite serious. First, a provider may not receive...more

Harris Beach Murtha PLLC

NY Department of Health Information for Pharmacies Submitting Medicaid 340B Drug Claims

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On April 1, 2023, Medicaid members enrolled in mainstream Managed Care (MC) plans, Health and Recovery Plans (HARPs) and HIV-Special Needs Plans (SNPs) began receiving pharmacy benefits from NYRx, the pharmacy program under...more

Cozen O'Connor

AG Healey Settles with Mental Health Provider Over Alleged False Claims

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Massachusetts AG Maura Healey and the DOJ reached a settlement with outpatient mental health company Pathways of Massachusetts, LLC (“Pathways”) and its former parent company Molina Healthcare, Inc. (“Molina”) to resolve...more

Harris Beach Murtha PLLC

Advancing Medicaid Payment Reform, New York State Publishes Value Based Payment Reporting Requirements

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On May 26, the New York State Department of Health (“DOH”) published the 2022 Value Based Payment (VBP) Reporting Requirements Technical Specifications Manual, available on the DOH website. Value Based Payment (VBP) refers to...more

Rivkin Radler LLP

NYS Budget Aims to Keep Network of CDPAP Fiscal Intermediaries Intact

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In December 2019, the New York State Department of Health (DOH) issued a Request for Offers (RFO) from fiscal intermediaries (FIs) to enter into contracts with the DOH to provide FI services in the Consumer Directed Personal...more

Foley Hoag LLP - Medicaid and the Law

New State Health Official Letter Extends Post-PHE Processing Timelines, Implements Redetermination Requirement

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We’ve previously discussed the numerous flexibilities CMS offered state Medicaid programs to respond to local outbreaks and address health concerns associated with the COVID-19 public health emergency (PHE). Back in...more

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