Category Archives: Legislation

Renewed Focus on Medicaid Home and Community-Based Services

Due to the COVID-19 pandemic, most people have spent considerably more time at home over the past year. For many, this meant long hours of Netflix binging, crossword puzzles, and the occasional zoom happy hour. But for some of the most vulnerable Americans, stay at home orders and social distancing have caused significant interruptions in access to health care services, including preventative doctor visits, medication management and nutritional services.… More

New House of Representatives COVID Relief Bill Contains Multiple Medicaid Provisions

Here at the Medicaid and the Law Blog, we’ve spent the past couple of days going through the American Rescue Plan Act, legislation introduced in the U.S. House of Representatives last Friday that is the latest attempt by Congress to respond to the COVID-19 pandemic.  There are several provisions of the legislation that would revise and expand the Medicaid program, and we thought it would be of interest to highlight them here. … More

Coverage of Routine Clinical Trial Costs Under the Medicaid Program

Right before the new year, we told you about some of the Medicaid-related provisions of the COVID relief package that was recently signed into law by President Trump.  One provision of that law that we thought merited a separate article was a new requirement that state Medicaid plans cover the routine patient costs of items and services furnished in connection with the participation by a Medicaid beneficiary in a routine clinical trial. … More

Medicaid Provisions in COVID-19 Relief Package

Here at the Medicaid and the Law Blog, we spent part of our holiday break reading through the most recent COVID-19 relief package that was finally signed into law by President Trump amid a not-insignificant amount of drama.  It was quite an undertaking; the new law is over 5,000 double-spaced pages.  While much of the legislation is related specifically or more generally to COVID-19 and economic recovery,… More

HHS Updates Medicaid Safety Net Payment Policies

Last month, we described the announcement by the Department of Health and Human Services (HHS) announcing the allocation to Medicaid providers under the Coronavirus Aid, Relief, and Economic Security (CARES) Act.  In the past couple of days, HHS has updated its policies regarding the Medicaid allocation (including the allocation to safety net providers) and we thought now would be a good time to highlight those updated policies.

By way of background,… More

In Latest Medicaid Rule, CMS Aims to Define Line Extensions

As many of our astute readers are aware, on June 17, 2020 CMS released a long-awaited Medicaid proposed rule addressing a number of far-ranging issued involving Medicaid coverage and payment for prescription drugs, including new regulations to encourage the development value-based purchasing arrangements between states and manufacturers. Over the next several days we will be posting our thoughts on a number of these key policy proposals, including CMS’… More

The COVID-19 Pandemic and Implications for Medicaid

Since the COVID-19 pandemic began to seriously affect the United States in March, Congress has passed four major pieces of legislation to address the public health crisis.  CMS has also jumped into action and has issued a series of waivers designed to ensure that the American health care system can function without bureaucratic obstacles preventing the appropriate delivery of care.  Today, we want to highlight some of the major Medicaid provisions of those four pieces of legislation;… More

MACPAC Expresses Concern Regarding Payments to High-Medicaid Providers During Coronavirus Pandemic

We haven’t posted on the blog in a while due to the rapid increase in our workload due to the coronavirus pandemic.  We’re preparing a longer post that will go through everything that’s happened in Medicaid legislatively and administratively in the past six weeks that will be up soon, but wanted to flag an important development in today’s post.

On March 27, President Trump signed the Coronavirus Aid,… More

CMS Issues Guidance on FMAP Increase During COVID-19 Outbreak

As my colleague Tom Barker wrote last week, the second emergency COVID-19 supplemental bill (officially referred to as the Families First Coronavirus Response Act), signed by the President on March 18, 2020, included a new section 6008 increasing each state Medicaid program’s federal medical assistance percentage (FMAP) by 6.2% during the period of the current national emergency to the extent they abide by certain minimum standards.… More

The COVID-19 Pandemic and Medicaid (UPDATED)

The global pandemic caused by the novel corona virus has certainly shaken up our normal way of life and will do so for the foreseeable future.  Times like this reinforce the importance of public health insurance programs like Medicare and Medicaid.  Our post today addresses many of the ways that CMS and Congress are bolstering the Medicaid program to respond to the unique challenges posed by the pandemic.  We’ve updated this post to reflect the fact that,… More

Senate Finance Committee Proposes Significant Drug Pricing Reforms in Medicaid

On July 25, 2019 the Senate Finance Committee voted to advance their long-awaited drug pricing package to the Senate floor (we anticipate a Floor vote sometime this Fall). The Prescription Drug Pricing Reduction Act (PDPRA) of 2019, as the package is called, proposes numerous drug pricing reforms across Federal healthcare programs (including Part B and Part D), but for today’s blog post we will focus on some of the many Medicaid provisions included in the final mark-up.… More