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Medicaid › Patient Access › Healthcare Reform

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

Maryland PDAB Releases Draft Upper Payment Limit Action Plan

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On August 9, Maryland’s Prescription Drug Affordability Board (PDAB) released its draft action plan for establishing upper payment limits (UPLs) for drugs identified as causing or likely to cause affordability challenges. The...more

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Understanding State Prescription Drug Affordability Board Landscape in Three Infographics

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Several states are considering or have enacted legislation to create prescription drug affordability boards (PDABs)....more

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Maryland Expands Access to Gender-Affirming Care

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On January 1, 2024, Maryland’s Trans Health Equity Act (THEA) went into effect, requiring the state’s Medicaid program to cover all medically necessary gender-affirming services, including services that were not previously...more

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FY 2025 Executive Budget Women’s Health Highlights

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Earlier this week, Governor Kathy Hochul released her Executive Budget proposal totaling $233 billion for State Fiscal Year 2025. The budget proposes several initiatives targeted at improving access to, quality of, and...more

Manatt, Phelps & Phillips, LLP

Advancing Health Equity: State Medicaid Actions to Ensure Access to Gender-Affirming Care

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The transgender, or trans, community experiences stark health disparities resulting from discrimination, violence, stigma and a lack of culturally competent providers. Compared with the general U.S. population, trans...more

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Increasing Community Health Workers’ Role in Supporting Medicaid Members

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Community health workers (CHWs) are frontline public health workers who come from and/or have deep roots in the communities they serve. Many states are leveraging CHWs to build trusting relationships with patients, including...more

Nossaman LLP

CMS Attempts to Reduce Appointment Times for Medicaid and CHIP Patients - How Will This Impact Your Managed Care Plan?

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A recent survey found that the average wait time for a new patient to see a physician in 15 of the largest cities in the U.S. was 26 days, up from 24.1 days in 2017.  Timely access to health care providers has long been an...more

Fenwick & West Life Sciences Group

A Complex Regulatory Landscape Emerges for Telemedicine

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Every year, Rock Health surveys the digital health landscape, noting the changing trends related to adoption by providers, patients and payers of these innovative new technologies....more

Burr & Forman

Hot Topics in Health Care - November 2022

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Physician Groups Voice Strong Opposition to Proposed Expanded Scope of Practice for Non-Physician Practitioners - The American Medical Association and over 80 other physician industry groups have come out in strong...more

Manatt, Phelps & Phillips, LLP

In Pursuit of Whole-Person Health: An Update on DOH Initiatives in Medicaid Managed Care Contracts

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Editor’s Note: There is mounting evidence that addressing the social and economic factors that drive the majority of health outcomes, often called social drivers of health (DOH), can improve health, promote health equity and...more

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Executive Summary: Tracking Telehealth Changes State-by-State in Response to COVID-19 - May 2022

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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

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

Manatt, Phelps & Phillips, LLP

COVID-19-Related Flexibilities: Moving Toward More Person-Centered Medicare and Medicaid Programs

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Editor’s Note: Over the course of the COVID-19 public health emergency (PHE), a series of Medicare and Medicaid regulatory flexibilities were implemented to help ensure access to care for older adults and people with chronic...more

Manatt, Phelps & Phillips, LLP

Executive Summary: Tracking Telehealth Changes State-by-State in Response to COVID-19 - March 2022

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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 servic es. Telehealth is an essential tool in ensuring patients are able to access...more

Manatt, Phelps & Phillips, LLP

COVID-19 State Resource Guide Update: Leveraging Federal and State Authorities to Ensure LTSS Access

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Editor’s Note: Since the start of the COVID-19 pandemic, federal and state policymakers have acted to preserve access to services for populations that use Medicaid-covered long-term services and supports (LTSS). These...more

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

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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

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Centering Health Equity in Medicaid: Section 1115 Demonstration Strategies

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Longstanding structural racism and related health inequities experienced by people of color further laid bare by the COVID-19 pandemic have mobilized leadership in many states to take action on health equity. Structural...more

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Executive Summary: Tracking Telehealth Changes State-by-State in Response to COVID-19 - February 2022

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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 servic es. Telehealth is an essential tool in ensuring patients are able to access...more

Manatt, Phelps & Phillips, LLP

Executive Summary: Tracking Telehealth Changes State-by-State in Response to COVID-19 - January 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 servic es. Telehealth is an essential tool in ensuring patients are able to access...more

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Senate Lays Groundwork for Fall Health Care Negotiations Before Recessing This Month

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The Big Picture - Before leaving for its August recess, the Senate made progress on two major Biden Administration priorities by passing bipartisan infrastructure legislation and a fiscal year (FY) 2022 budget resolution....more

Hogan Lovells

Ramping up the drug pricing debate: Dueling bills and paying for health care infrastructure

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The U.S. House of Representatives is considering dueling proposals related to drug pricing under Medicaid and Medicare, including the Republican-led H.R. 19, the “Lower Costs, More Cures Act of 2021” and a reintroduced...more

Morgan Lewis

President Biden Expands Access to Affordable Care Act Exchange Plans, Women’s Reproductive Health

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January 28 was designated as “health day” for President Joe Biden’s early push of executive orders, with two new executive actions added to a growing list. The Executive Order on Strengthening Medicaid and the Affordable Care...more

Bricker Graydon LLP

Ohio Medicaid telehealth changes made permanent

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At the start of the COVID-19 pandemic, the Ohio Department of Medicaid (ODM) acted quickly to implement an emergency telehealth rule, Ohio Administrative Code §5160-1-21. This rule temporarily expanded the scope of telehealth...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

Sheppard Mullin Richter & Hampton LLP

Federal Regulatory Developments Brewing in Telehealth

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Two federal agencies – the Centers for Medicare and Medicaid Services (“CMS”) and the Federal Communications Commission (“FCC”) – announced separate initiatives last week that stand to increase patient access to telehealth...more

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