News & Analysis as of

Public Health Emergency Medicaid

Rivkin Radler LLP

Court: Mailing Drugs to Patients’ Homes is a Potential Stark Law Violation

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A recently issued federal court opinion confirmed that certain pre-COVID era prescribing restrictions are back in place. In July 2023, a nonprofit advocacy group, Community Oncology Alliance, filed suit against the U.S....more

Baker Donelson

Temporary Regulatory Relief for North Carolina Health Care Providers Responding to Helene

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North Carolina Governor Roy Cooper declared a State of Emergency on September 25, 2024, due to the impending impact of Tropical Storm Helene (Helene). On September 28, 2024, a Federal Major Disaster Declaration (FEMA-4827-DR)...more

King & Spalding

Biden Administration Streamlines CHIP and Medicaid Enrollment, Expands Protections for Covered Population

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Last week, the Biden-Harris administration (the Administration) announced a new rule simplifying the process for enrolling in Medicaid, the Children’s Health Insurance Program (CHIP), and the Basic Health Program (BHP)....more

Sheppard Mullin Richter & Hampton LLP

Continuity in Coverage: CMS Extends the Unwinding SEP & Issues Final Rule for Medicaid and CHIP Enrollment

On March 28, 2024, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced that it is extending the temporary special enrollment period (the Unwinding SEP)...more

Stotler Hayes Group, LLC

The Great Unwinding And Its Effect On Skilled Nursing Facilities

Following the termination of the Public Health Emergency (“PHE”) as a result of COVID-19, and the continuous enrollment provisions put in place to ensure that Medicaid beneficiaries were able to receive Medicaid benefits...more

McDermott+

President Biden Releases FY 2025 Budget: What’s NOT in It?

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Earlier this week, President Biden released his Fiscal Year (FY) 2025 President’s Budget. As a reminder, every year, the White House releases a budget that serves as its official funding request to Congress for the following...more

Alston & Bird

Health Care Week in Review: CMS Finalizes Medicaid DSH Rule and House Launches Bipartisan AI Task Force

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Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

King & Spalding

CMS Issues Interim Final Rule for CMS Enforcement of State Compliance with Reporting and Federal Medicaid Renewal Requirements

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On December 4, 2023, CMS issued an interim final rule (the Interim Rule) (RIN 0938-AV26) to implement new enforcement authorities that CMS may use if states fail to comply with new reporting requirements or with federal...more

McDermott+

Enforcing State Redeterminations of Medicaid Eligibility

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As we continue to “unwind” from the COVID-19 public health emergency (PHE), we are still very much in a transition period. Many of the policies that beneficiaries, providers, plans and states came to rely on during the...more

Morgan Lewis - Health Law Scan

Medicaid’s Unwinding: Significant Disenrollments Will Affect Plans, Providers, and Patients

Estimates show that Medicaid enrollment grew by more than 20 million (approximately 31%) during the public health emergency (PHE) and the top Medicaid managed care organizations (MCOs) experienced a 44.1% increase in managed...more

Manatt, Phelps & Phillips, LLP

Leveraging Medicaid to Support Children and Youth Living With Complex Behavioral Health Needs

Editor’s Note: In a new report prepared for The Commonwealth Fund, Manatt Health and its co-authors provide an actionable framework and strategies for how state-level policymakers can use Medicaid and the Children’s Health...more

Robinson+Cole Health Law Diagnosis

HRSA Confirms End of COVID Waiver of Advance Registration Requirement for Provider-Based Clinics

On September 27, 2023, the Health Resources and Services Administration (HRSA) issued a Notice in the Federal Register applicable to all 340B Program hospitals that formally ends a COVID-era waiver of the long-standing HRSA...more

Manatt, Phelps & Phillips, LLP

The Impact of Medicaid Telehealth Policy Change on Equitable Access to Telehealth Services in NC

Editor’s Note: In a new issue brief published by the Milbank Memorial Fund and summarized below, Manatt Health and leadership from the North Carolina Department of Health and Human Services (NC DHHS) share insights into...more

Manatt, Phelps & Phillips, LLP

Telehealth Policy Lessons Learned in North Carolina During the COVID-19 Pandemic and Beyond

Introduction - The COVID-19 pandemic catalyzed a dramatic rise in the use of telehealth nationwide to deliver services to individuals enrolled in Medicaid and the Children’s Health Insurance Program (CHIP). The federal...more

Manatt, Phelps & Phillips, LLP

[Webinar] The Legal, Regulatory and Market Trends Transforming Health Care - October 5th, 9:30 am - 10:30 am PT

From the end of the COVID-19 public health emergency (PHE) to the overturning of Roe v. Wade to the skyrocketing growth of virtual care, multiple forces are converging to remap the health care landscape. In a new webinar,...more

Manatt, Phelps & Phillips, LLP

Executive Summary: Tracking Telehealth Changes State-by-State in Response to COVID-19 - August 2023 #2

Payment Parity: Permanent State Laws and Statutes - Payment Parity requires that health care providers are reimbursed the same amount for telehealth visits as in-person visits. During the COVID-19 pandemic, many states...more

Manatt, Phelps & Phillips, LLP

Executive Summary: Tracking Telehealth Changes State-by-State in Response to COVID-19 - August 2023

Illinois passed S.B. 1913, which requires Medicaid FFS and Medicaid managed care plans to provide coverage of mental health services, substance use disorder treatment, and ‘behavioral telehealth services’. Requires Medicaid...more

Manatt, Phelps & Phillips, LLP

Proposed CY 2024 Medicare Physician Fee Schedule Extends Many Telehealth Flexibilities Through 2024

On July 13, the Centers for Medicare & Medicaid Services (CMS) released its annual proposed rule updating the Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2024, which includes various proposed changes related...more

Manatt, Phelps & Phillips, LLP

Executive Summary: Tracking Telehealth Changes State-by-State in Response to COVID-19 - June 2023 #2

H.R. 4189 / S. 2016: Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act ....more

King & Spalding

CMS Lifts COVID-19 Vaccine Requirements for Long Term Care Facilities

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On May 31, 2023, CMS issued a final rule (Final Rule) repealing COVID-19 vaccination requirements for staff and testing requirements for staff and patients of long-term care (LTC) facilities. These were previously required...more

Holland & Knight LLP

Holland & Knight Health Dose: May 31, 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

Manatt, Phelps & Phillips, LLP

Telehealth Monitoring, Research and Evaluation: Issues for State Medicaid Agencies to Consider

Background - The use of telehealth increased exponentially in 2020 and 2021 as health care providers and patients responded to the COVID-19 pandemic. The Government Accountability Office (GAO) estimated that the use of...more

King & Spalding

HHS Announces Continuing Telehealth Flexibilities Following the End of the COVID-19 PHE

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On May 10, 2023, HHS announced that many telehealth and teleprescribing flexibilities will remain in place after the end of the COVID-19 Public Health Emergency (PHE) on May 11, 2023. Congress extended many telehealth...more

King & Spalding

HHS Announces the End of the COVID-19 Public Health Emergency

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On May 9, 2023, HHS released a fact sheet announcing the expiration of the COVID-19 Public Health Emergency (PHE) on May 11, 2023. HHS also provided information on changes to the healthcare flexibilities issued during the...more

Holland & Knight LLP

Holland & Knight Health Dose: May 16, 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

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