Newsletters

07.06.16

Manatt on Health Reform: Weekly Highlights, July 6, 2016

Massachusetts extends coverage of Hepatitis C treatments and New Hampshire extends substance use disorder coverage to more Medicaid enrollees; Alaska’s Medicaid expansion now moves ahead uncontested; and CMS reports HealthCare.gov’s latest enrollment numbers.


06.30.16

Manatt on Medicaid: Monthly Expansion Recap, June 2016

The Department for Medicaid Services released a draft 1115 demonstration application to transform the coverage options available under Medicaid expansion (named "Kentucky HEALTH"), as well as introduce delivery system reforms targeting substance use disorder (SUD), chronic disease ...


06.30.16

Transparency and Decision Support for Medicaid Managed Care Consumers

Today three-quarters of the over 60 million Americans enrolled in Medicaid will access some or all of their coverage through managed care.


06.29.16

Manatt on Health Reform: Weekly Highlights, June 29, 2016

Kentucky proposes premium assistance and high deductible health plans to cover expansion enrollees under an 1115 waiver; New York Legislature expresses unanimous support for a reimbursement increase for safety-net hospitals; and a new literature review documents Medicaid expansion's positive ...


06.23.16

Real-Time Data Analytics in Government Investigations and Reducing Exposure

It is not every day that the words “innovative” and “nimble” are used when referring to an agency of the federal government bureaucracy. Yet, after studying the playbook of sophisticated corporations, the Health Care Fraud Prevention and Enforcement Action Team (HEAT), run ...


06.22.16

CMS Revises Process for Determining MMC Payments

In its April 25, 2016 Medicaid managed care final rule, the Centers for Medicare and Medicaid Services (CMS) provides a revised framework for determining how managed care plans should be paid by state Medicaid programs.


06.21.16

Manatt on Health Reform: Weekly Highlights, June 21, 2016

Massachusetts releases $1.8 billion DSRIP program waiver for public comment; CMS awards $32 million in grants to enroll uninsured children in Medicaid/CHIP; and Wisconsin withdraws proposed changes to Medicaid long-term care.


06.16.16

CMS Dramatically Expands Guidance on MMC Plan Payment

In its April 25, 2016 Medicaid managed care final rule, the Centers for Medicare and Medicaid Services (CMS) addresses a core issue: how managed care plans should be paid by state Medicaid programs.


06.14.16

Manatt on Health Reform: Weekly Highlights, June 14, 2016

CMS targets short-term insurance plans as it takes action in efforts to stabilize the individual market risk pool; Illinois mandates Medicaid coverage for opioid addiction treatment; and the Michigan legislature seeks to restructure state Medicaid financing.


06.13.16

CMS Clarifies Medicaid Managed Care Prescription Drug Access

The recently finalized Medicaid managed care regulations clarify an important point about prescription drug coverage in Medicaid managed care plans. Just as is the case in fee-for-service (FFS) Medicaid, beneficiaries enrolled in Medicaid managed care plans are entitled to any medically necessary ...