Newsletters

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.


06.16.16

Dietary Supplement Makers Reach Deal With FTC

The makers of a dietary supplement touted to help users lose weight and aid with the symptoms of menopause settled with the Federal Trade Commission over charges that their claims were unsubstantiated and violated Section 5 of the Federal Trade Commission Act.


06.16.16

A Tale of Two Suspensions

The recent suspension of Draymond James by the NBA compares very favorably with the NFL's suspension of Tom Brady, regardless of the correctness of the decisions.


06.16.16

False Claims Act: Supreme Court Decides Implied Certification Case

On June 16, 2016, the Supreme Court decided Universal Health Services v. U.S. ex rel. Escobar, holding that the implied false certification theory can be a basis for False Claims Act liability if a claim for payment makes specific representations about the services provided but fails to disclose ...


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

Unionless College Athletes Need an Ombudsman

The recent decision of the Big 12 Conference to have a championship game demonstrates the problems of amateurism.


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 ...


06.10.16

New York's DFS Reaches $3M Deal Involving Payday Lending Debts

Continuing its efforts against payday lenders, New York's Department of Financial Services (DFS) announced a consent decree with National Credit Adjustors (NCA) and Webcollex totaling $3 million.


06.08.16

Why You Should Continue to Pay Attention to PACE

With commercial property owners and tenants still seeking sustainable building designs that incorporate energy efficiency or green building features, Property Accessed Clean Energy (PACE) financing will continue to rightfully receive more attention.


06.07.16

Manatt on Health Reform: Weekly Highlights, June 7, 2016

Arkansas’ Governor requests to transition to a “State-based Marketplace on the Federal Platform;” Louisiana launches Medicaid expansion with SNAP fast-track enrollment; and 2016 premium increases are lower for on-Marketplace than off-Marketplace plans.