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Medicaid › Medical Reimbursement › Medicare

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 -
Manatt, Phelps & Phillips, LLP

Manatt Telehealth Policy Tracker: Tracking Ongoing Federal and State Telehealth Policy Changes

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2024: New Federal Developments - There were no relevant federal developments during Q2 of 2024. 2024: New State-Level Developments...more

Dorsey & Whitney LLP

Tribes Win Healthcare Contract Support Costs at Supreme Court

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On June 6, 2024, the Supreme Court issued its decision in the consolidated cases of Becerra v. San Carlos Apache Tribe (No. 23-250) and Becerra v. Northern Arapaho Tribe (No. 23-253)....more

Snell & Wilmer

Supreme Court Ruling Supports Tribal Healthcare Funding and Self-Determination

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By Heidi McNeil Staudenmaier and Kelsey Haake  In a momentous decision on June 6, 2024, the U.S. Supreme Court delivered a resounding victory for Native American tribes. The Court ruled that the Indian Health Service (IHS)...more

WilmerHale

In Narrow Victory for Tribal Nations, US Supreme Court Requires Federal Government to Reimburse Tribal Nations for Healthcare...

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On June 6, 2024, the US Supreme Court decided Becerra v. San Carlos Apache Tribe and Becerra v. Northern Arapaho Tribe (Nos. 23-250 and 23-253), holding that the Indian Health Service (IHS) must reimburse Native nations,...more

Manatt, Phelps & Phillips, LLP

Accessing Cell and Gene Therapies : Insights on Coverage, Reimbursement and Emerging Models

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Over the past five years, cell and gene therapies have increasingly moved from the R&D pipeline to the health care setting, putting lifesaving treatments for certain cancers and genetic diseases within patients’ reach. Over...more

Manatt, Phelps & Phillips, LLP

Executive Summary: Tracking Telehealth Changes State-by-State in Response to COVID-19 - April 2022 #2

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As the COVID-19 pandemic continues across the United States, states, payers, and providers are looking for ways to expand access to telehealth services. Telehealth is an essential tool in ensuring patients are able to access...more

Pullman & Comley - Connecticut Health Law

Short Staffing May Still be Hindering Health Care in Connecticut but OIG's Exclusion Authority Remains Alive and Well

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Can a 40-year-old fraud and abuse law that compared to many others is relatively straightforward still get providers into trouble?  Answer: You bet!  In fact, in the first quarter of 2022 alone, the U.S. Attorney for the...more

Polsinelli

Health Care Reimbursement and Payor Dispute Update Special Edition - Year End Regulatory Review

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The end of 2021 brings positive indications of the continued acceptance of telehealth as an important clinical care approach post public health emergency (“PHE”). The Centers for Medicare and Medicaid Services (“CMS”), like...more

Manatt, Phelps & Phillips, LLP

Executive Summary: Tracking Telehealth Changes State-by-State in Response to COVID-19 - August 2021 #2

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As the COVID-19 pandemic continues across the United States, states, payers, and providers are looking for ways to expand access to telehealth services. Telehealth is an essential tool in ensuring patients are able to access...more

Robinson+Cole Health Law Diagnosis

CMS Announces New Telehealth Services Covered by Medicare and Provides States with Medicaid and CHIP Telehealth Expansion...

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On October 14, 2020, the Centers for Medicare & Medicaid Services (CMS) expanded the list of telehealth services covered by Medicare during the COVID-19 Public Health Emergency. CMS also announced it would be providing...more

King & Spalding

CMS Issues Medicare IPPS and LTCH Final Rule for FY 2021

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On September 2, 2020, CMS issued the fiscal year (FY) 2021 final rule for the hospital inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective payment system (the Final Rule). This article...more

Chambliss, Bahner & Stophel, P.C.

Can You Transfer Your Medicare and Medicaid Plans When You Move to Another State?

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If you plan to move states, can you take your Medicare or Medicaid plans with you? The answer depends on whether you have original Medicare, Medicare Advantage, or Medicaid. Medicare - If you have original Medicare...more

Polsinelli

Health Care Reimbursement and Payor Dispute Update - August 2020

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Introduction - CMS has taken extensive measures to assist providers and promote access to care in light of the Public Health Emergency (PHE) related to the COVID-19 pandemic. The efforts taken have and continue to benefit...more

McGuireWoods LLP

Healthcare Private Equity and COVID-19: Eight More Things to Consider as Pandemic Continues

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As effects from the 2019 novel coronavirus (COVID-19) pandemic set in, stay-at-home orders and business closures are disrupting American lives and businesses. The healthcare industry is no exception, with the pandemic both...more

Robinson+Cole Health Law Diagnosis

Federal Government Significantly Expands Telehealth Reimbursement During COVID-19 Public Health Emergency

Robinson+Cole Health Law Diagnosis on

On March 17 the Trump Administration announced expanded reimbursement for clinicians providing telehealth services for Medicare beneficiaries during the COVID-19 Public Health Emergency. The Centers for Medicare and Medicaid...more

Sheppard Mullin Richter & Hampton LLP

CMS Proposes New Home Health Agency Rule Including Potential Changes to Reimbursement, Coverage, Quality, and More: CMS Accepting...

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On July 11, 2019, the Centers for Medicare and Medicaid Services (“CMS”) announced a proposed rule for home health agency Medicare reimbursement that would increase payments by an aggregate 1.3% for 2020, amounting to $250...more

Hogan Lovells

Regulatory Insights for Life Sciences and Health Care Investments: Drug Pricing and Reimbursement

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Investing in the life sciences industry without an understanding of the key regulatory factors that could determine a product's success or failure could cost you millions of dollars....more

Holland & Knight LLP

Healthcare Law Update: September 2018

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Regulation - CMS Contemplating Telemedicine Changes - The Centers for Medicare & Medicaid Services (CMS) recently published what it described as a "major proposed rule" that covers a number of topics that could have...more

Robinson+Cole Health Law Diagnosis

OIG Posts Telemedicine Advisory Opinion

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The Office of Inspector General (OIG), Health and Human Services issued an Advisory Opinion allowing an arrangement proposed by a federally qualified health center look-alike (FQHC look-alike) to provide free technology items...more

Dickinson Wright

As Telemedicine Soars, Reimbursement for Telemedicine Services Slowly Evolve

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The use of telemedicine has soared in recent years, as new technologies develop and consumer demand for instant access to healthcare increases. ...more

Robinson+Cole Health Law Diagnosis

CMS Revises National Coverage Determination for Implantable Cardioverter Defibrillators

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On February 15, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a Decision Memo outlining revisions to its 2005 National Coverage Determination (NCD) for Implantable Automatic Defibrillators (ICDs) ....more

Akerman LLP - Health Law Rx

CMS Expands Reimbursement for Telehealth Services

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Despite telehealth’s significant expansion over the past ten years, it has been plagued by a historically unstable regulatory and reimbursement landscape....more

Dickinson Wright

The Trump Administration Proposes a Budget Increase to Fight Healthcare Fraud

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The Trump administration proposed a budget increase of 19 million to aid in the fight against health care fraud. This showcases the continued (and heightened) importance of anti-fraud programs, especially compared to the...more

Robinson+Cole Health Law Diagnosis

Escobar Compels Florida District Court to Overturn $350 Million Jury Verdict Arising from Claims of Inadequate Documentation

Robinson+Cole Health Law Diagnosis on

Last month, a U.S. District Court in the Middle District of Florida overturned judgments totaling $347,864,285 returned by a jury under the federal False Claims Act (FCA) and Florida’s state equivalent against the owners and...more

Mintz - Health Care Viewpoints

OIG Reaffirms Permissibility of Certain Gainsharing Arrangements

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The Department of Health and Human Services Office of the Inspector General (OIG) has issued an Advisory Opinion (Opinion) in connection with a hospital’s gainsharing arrangement (Arrangement) with a designated group of...more

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