Medicaid, Fee-for-Service, Centers for Medicare & Medicaid Services (CMS)

CMS Releases Technical Guidance to States on Complying with Medicaid Access Final Rule

Manatt, Phelps & Phillips, LLP on 7/25/2024

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

Designing a Medicaid Hospital Global Budget Under CMS’ AHEAD Model

Manatt, Phelps & Phillips, LLP on 7/5/2024

In September 2023, the Centers for Medicare and Medicaid Services (CMS) announced the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model, and this week CMS is expected to make a first set of...more

Medicaid: CMS Final Rules Aim to Expand Access, Provide Parity with Commercial Markets

Foley & Lardner LLP on 5/14/2024

The Centers for Medicare & Medicaid Services (CMS) published two significant updates to its Medicaid regulations on May 10, 2024. The two Final Rules, a Medicaid Access Rule and a Medicaid Managed Care Rule, impose new...more

CMS Finalizes Sweeping Regulations for Medicaid Access, Managed Care, and HCBS

Manatt, Phelps & Phillips, LLP on 5/3/2024

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

CMS Finalizes Major Reforms to Medicaid, Part 2: Medicaid Managed Care Reg

McDermott+ on 5/3/2024

Medicaid Regs Part 2! Last week, Regs & Eggs took a deep dive into the Ensuring Access to Medicaid Services final reg, one of two regs that the Centers for Medicare & Medicaid Services (CMS) released to add new requirements...more

Policy Update - CMS Releases Final Rule: Medicaid Program; Ensuring Access to Medicaid Services

McDermott+ on 4/29/2024

On April 22, 2024 the Centers for Medicare & Medicaid Services (CMS) published the Medicaid Program; Ensuring Access to Medicaid Services final rule. The rule has a particular focus on home- and community-based services...more

[Webinar] Final Medicaid Rules, Part Three: Home and Community Based Services - June 4th, 10:00 am - 11:00 am PT

Manatt, Phelps & Phillips, LLP on 4/18/2024

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

[Webinar] Final Medicaid Rules, Part Two: Managed Care Payments, Quality and Oversight - May 21st, 12:00 pm - 1:00 pm PT

Manatt, Phelps & Phillips, LLP on 4/16/2024

This program is part two 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

[Webinar] Final Medicaid Rules, Part One: Access, Enrollee Engagement and Provider Payment Transparency - May 14th, 12:00 pm -...

Manatt, Phelps & Phillips, LLP on 4/15/2024

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

CMS Issues Final Rule Aimed at Improving Prior Authorization Processes

King & Spalding on 1/26/2024

On January 18, 2024, CMS released a pre-publication version of a final rule (the Final Rule) that will require Medicare Advantage organizations (MA or Part C), Medicaid and the Children’s Health Insurance Program (CHIP)...more

Transforming Primary Care: CMS Launches Making Care Primary (MCP) Model

Mintz - Health Care Viewpoints on 8/9/2023

The Centers for Medicare & Medicaid Services (CMS) announced a new primary care model—the Making Care Primary (MCP) Model—geared towards smaller, independent primary care practices and organizations that want to participate...more

[Webinar] Proposed Rules on Medicaid Payments, Access and Quality: Implications for Health Care Stakeholders - June 20th, 1:00 pm...

Manatt, Phelps & Phillips, LLP on 6/9/2023

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

The Pennsylvania Rural Health Model: Lessons Learned and What’s Next for Rural Payment Policies

Manatt, Phelps & Phillips, LLP on 4/26/2023

Since 2010, a reported 140 rural hospitals have closed their doors, including a record 19 hospitals in 2020 alone as a result of the financial pressures of COVID-19 compounded by many other long-standing challenges facing...more

HHS Issues Report Outlining Three New Drug Models for Testing by CMMI

Foley Hoag LLP on 2/22/2023

On February 14, 2023, and in response to Executive Order 14087 (“Lowering Prescription Drug Costs for Americans”), the Secretary of Health and Human Services (HHS) issued a report announcing the selection of three models that...more

CMS Proposes Rule to Require Certain Health Plans to Electronically Share Data with Providers Regarding Prior Authorization...

King & Spalding on 12/21/2022

On December 13, 2022, CMS is set to publish in the Federal Register a proposed rule (Proposed Rule) requiring certain Medicare, Medicaid, Children’s Health Insurance Program, and Qualified Health Plan fee-for-service and...more

CMS Solicits Input on Potential Medicaid and CHIP Reforms Around Eligibility, Enrollment and Access

Manatt, Phelps & Phillips, LLP on 2/23/2022

On February 17, the Centers for Medicare & Medicaid Services (CMS) released a Request for Information (RFI) regarding the federal standards that govern access to care in Medicaid and the Children’s Health Insurance Program...more

CMS to the Rescue for MA and Part D Plans – Rate Announcement Includes Significant Increase in Plan Payments for 2022

Sheppard Mullin Richter & Hampton LLP on 1/28/2021

Over the last year, we have seen volatility in the healthcare industry overall, and Medicare Advantage (“MA”) and Medicare Part D plans (together, “Plans”) have not been immune. Particularly because of their risk adjustment...more

CMS Expands List of Telehealth Services Covered by Medicare

Jackson Walker on 10/22/2020

On October 14, 2020, the Centers for Medicare & Medicaid Services (CMS) expanded the list of telehealth services that Medicare Fee-For-Service will pay for during the coronavirus disease 2019 (COVID-19) public health...more

CMS Withdraws Proposed Medicaid Fiscal Accountability Regulation

ArentFox Schiff on 9/18/2020

The Centers for Medicare and Medicaid Services (CMS) has withdrawn its proposed Medicaid Fiscal Accountability Regulation (MFAR), according to a September 14, 2020, announcement via Twitter by Administrator Seema Verma. ...more

CMS Moves Toward Business as Usual With Provider Oversight and Claims Review in Medicare/Medicaid

Manatt, Phelps & Phillips, LLP on 8/26/2020

The COVID-19 crisis is far from over, as evidenced by the 300,000 new U.S. cases reported over the past seven days. Recognizing this ongoing impact, federal and state officials have left in place many of the emergency...more

CMS Rapidly Approves Section 1135 Waivers in Response to the COVID-19 Pandemic - Update

Bass, Berry & Sims PLC on 4/27/2020

This content was last updated as of Thursday, April 24 at 12:00 p.m. CST- The Centers for Medicare & Medicaid Services (CMS) continues its issuance of Section 1135 waivers, waiving or modifying certain Medicare, Medicaid,...more

HHS Pays Out $30 Billion of Relief Funds Based on Medicare Revenue, Indicates Future Distributions will be Based on Medicaid and...

Lathrop GPM on 4/16/2020

Health care providers began receiving direct deposits into their bank accounts on April 10, 2020 as part of the first disbursement of the $100 billion in provider relief funds allocated under the CARES Act. Providers are...more

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