Executive Summary -
Despite the demonstrated effectiveness of prenatal vaccines, uptake remains low. This puts mothers and babies at risk. Vaccines administered prenatally (i.e., during a pregnancy) provide protective...more
On September 26, the Centers for Medicare and Medicaid Services (CMS) released comprehensive guidance to states that reinforces and clarifies federal Medicaid requirements regarding Early and Periodic Screening, Diagnostics,...more
For states, managed care organizations, and providers—who all play a vital role in ensuring access to family planning services and supplies for the nearly 20 million women ages 18-44 enrolled in Medicaid1—the CIB reiterates...more
8/28/2024
/ Abortion ,
Best Practices ,
Centers for Medicare & Medicaid Services (CMS) ,
Contraceptives ,
Dobbs v. Jackson Women’s Health Organization ,
Family Planning Clinics ,
Health Insurance ,
Healthcare ,
Managed Care Contracts ,
Medicaid ,
New Guidance ,
Patient Access ,
Reproductive Healthcare Issues
On August 8, a coalition of 15 state attorneys general sued CMS in the North Dakota federal court seeking to overturn a May 2024 CMS final rule making Deferred Action for Childhood Arrivals (DACA) recipients eligible for...more
On July 12, CMS released a companion guide to the Ensuring Access to Medicaid Services final rule (the “Access Final Rule”). This technical guidance—which focuses on the provisions regarding fee-for-service (FFS) payment...more
On June 27, the D.C. District Court struck down CMS’ 2020 approval of a 10-year renewal for the Healthy Indiana Plan (HIP) 2.0 Medicaid Section 1115 demonstration (Rose v. Becerra). In addition to the atypical 10-year...more
On Monday, April 22, the Centers for Medicare & Medicaid Services (CMS) released two highly anticipated final rules. Together, these rules reshape the federal regulatory landscape for Medicaid and the Children’s Health...more
This program is part three of Manatt’s New Federal Rules on Medicaid Access and Managed Care webinar series.
After releasing sweeping proposed rules on Medicaid access and managed care in spring 2023, the Centers for...more
4/18/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Fee-for-Service ,
Final Rules ,
Health Care Providers ,
Home and Community Based Services (HCBS) ,
Home Health Care ,
MCOs ,
Medicaid ,
Provider Payments ,
Quality of Care Standards ,
Transparency ,
Webinars
This program is part one of Manatt’s New Federal Rules on Medicaid Access and Managed Care webinar series.
After releasing sweeping proposed rules on Medicaid access and managed care in spring 2023, the Centers for...more
Since becoming aware of the cyberattack on Change Healthcare in late February, the Centers for Medicare & Medicaid Services (CMS) has announced a number of flexibilities to support affected providers that have experienced...more
The Big Picture -
On December 13, 2023, the Supreme Court announced its intention to review the August 16 ruling by the Fifth Circuit in Alliance for Hippocratic Medicine (AHM) v. U.S. Food and Drug Administration, et al....more
12/20/2023
/ Abortion ,
Alliance for Hippocratic Medicine v Food and Drug Administration ,
Article III ,
Certiorari ,
Dobbs v. Jackson Women’s Health Organization ,
Equal Protection ,
Food & Drug Regulations ,
Food and Drug Administration (FDA) ,
Generic Drugs ,
Healthcare ,
Human Rights ,
Life Sciences ,
Medical Necessity ,
Patient Access ,
Pregnancy ,
Prescription Drugs ,
REMS ,
Reproductive Healthcare Issues ,
Roe v Wade ,
SCOTUS ,
Standing ,
Women's Rights
EXECUTIVE SUMMARY -
Clinical trials are a lifesaving option for many cancer patients. But too many patients face barriers preventing access to this critical treatment.
Everyone suffers when patients cannot access...more
On Wednesday, August 16, the Fifth Circuit Court of Appeals issued a ruling upholding parts of a Texas district court’s decision that would, if it becomes effective, severely limit access to mifepristone, one of two pills...more
8/23/2023
/ Abortion ,
Department of Justice (DOJ) ,
Drug Distribution ,
Food and Drug Administration (FDA) ,
Healthcare ,
Life Sciences ,
Patient Access ,
Pharmaceutical Industry ,
Pharmacies ,
Prescription Drugs ,
REMS ,
Reproductive Healthcare Issues ,
SCOTUS ,
Women's Rights
On Thursday, April 27, the Centers for Medicare & Medicaid Services (CMS) released two highly anticipated proposed rules... Together, these would reshape the federal regulatory landscape for Medicaid and the Children’s Health...more
6/9/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Fee-for-Service ,
Health Care Providers ,
Health Insurance ,
Home and Community Based Services (HCBS) ,
Managed Care Contracts ,
Medicaid ,
Payment Rates ,
Proposed Rules ,
Provider Payments ,
Quality of Care Standards ,
State Medicaid Programs ,
Webinars
Editor’s Note: In a new white paper funded by Pfizer, Inc., Manatt Health discusses the current landscape of Medicaid and Children’s Health Insurance Program (CHIP) coverage and reimbursement for prenatal vaccines, informed...more
The Department of the Treasury (the Treasury) has indicated that absent congressional action to suspend or raise the debt limit, the federal government will likely be unable to satisfy all of its financial obligations as...more
Prenatal vaccines provide important protection for pregnant women and newborns against communicable diseases such as whooping cough and influenza. However, fewer than one out of four pregnant women receives all federally...more
5/18/2023
/ Children's Health Insurance Program (CHIP) ,
Continuing Legal Education ,
Denial of Insurance Coverage ,
Fee-for-Service ,
Health Care Providers ,
Health Insurance ,
Infectious Diseases ,
MCOs ,
Medicaid ,
Payment Rates ,
Pharmaceutical Industry ,
Pharmacist ,
Physicians ,
Pregnancy ,
Reimbursements ,
Vaccinations ,
Webinars
Prenatal vaccines—those administered during a pregnancy—provide crucial protections to pregnant women and/or newborns against communicable diseases such as whooping cough and influenza. Additional prenatal vaccines are in...more
5/17/2023
/ Affordable Care Act ,
Children's Health Insurance Program (CHIP) ,
Fee-for-Service ,
Food and Drug Administration (FDA) ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
MCOs ,
Medicaid ,
Medicare ,
Patient Access
At 11:59 p.m. on Thursday, May 11, 2023, the COVID-19 public health emergency (PHE) declaration will conclude, more than three years after taking effect in January 2020. The PHE declaration has enabled the U.S. Department of...more
On April 27, 2023, the Centers for Medicare & Medicaid Services (CMS) released proposed rules that, if finalized, would reshape Medicaid’s federal regulatory landscape in several ways, including with respect to home and...more
The Big Picture -
Less than one year after the Supreme Court overturned the federal constitutional right to abortion in Dobbs v. Jackson Women’s Health Organization and “returned [the issue of abortion back] to the people...more
The Affordable Care Act (ACA) requirement for commercial coverage of certain preventive services without cost sharing is unenforceable, according to a March 30 decision in Braidwood Management, Inc. v. Becerra by Judge Reed...more
The Biden Administration has announced that May 11, 2023, will be the final day of the COVID-19 public health emergency (PHE) declaration, which has been in effect since January 2020. Following the White House’s announcement...more
In the aftermath of the Dobbs v. Jackson Supreme Court decision, there is ongoing discussion about the role that medication abortion—particularly tele-medication abortion (teleMAB)— will play in connecting women to abortion...more
The Big Picture -
On September 23, the Centers for Medicare & Medicaid Services (CMS) reopened the comment period for a November 2020 interim final rule (IFR) titled “Additional Policy and Regulatory Revisions in Response...more