Articles and Blogs

On November 14, 2025, the Centers for Medicare & Medicaid Services (“CMS”) issued a letter, which it describes as “preliminary guidance,” concerning two significant restrictions on Medicaid provider taxes set forth in H.R. 1, including: (i) a change in the indirect hold harmless threshold for provider taxes—which, in effect, prohibits states from increasing the... READ MORE

In the latest effort to increase price transparency and lower prescription drug costs, the Centers for Medicare & Medicaid Services (“CMS”) issued a proposed rule (“Proposed Rule”) that, in part, intends to reveal the actual cost of drugs covered by Medicaid. The Proposed Rule includes two new initiatives: A Medicaid managed care organization (“MCO”)... READ MORE

On June 8, 2023, the Centers for Medicare & Medicaid Services (“CMS”) announced the Making Care Primary Model (“Model”), a new multi-payor, voluntary primary care model tested by the Center for Medicare and Medicaid Innovation (“CMMI”) and aimed at strengthening the primary care infrastructure for Medicare and Medicaid patients. The Model focuses on primary... READ MORE

March 17, 2023, was the transition period deadline for full state compliance with the Home and Community-Based Services (“HCBS”) Final Regulation.  As part of the steps to get ready for this deadline, in late 2022, the Centers for Medicare & Medicaid Services (“CMS”) visited several settings in multiple states that were identified by the... READ MORE

This latest installment of our series on HHS Provider Relief Funding focuses on the new Medicaid Targeted Distribution, the postponement of the July 10 reporting deadline and new and updated FAQs. Since our last Bulletin posted June 12, found here, HHS has posted 45 new or modified FAQs, including 20 dated June 25. Many... READ MORE

On March 25, 2020, the Senate passed the Coronavirus Aid, Relief, and Economic Security Act (H.R. 748) (“CARES Act” or “Act”). The CARES Act contains numerous provisions aimed at the response to the Coronavirus or COVID-19 pandemic, including $100 billion in reimbursement to hospitals and other health care entities for COVID-19-related expenses and lost... READ MORE

Surprise Billing Continues to Be Hot as More Committees Weigh In The House Ways & Means Committee plans to release its surprise billing legislation this week in preparation for a markup on February 12. The Ways and Means proposal will rely on arbitration for resolving out of network claims and will have to be... READ MORE

For the fifth time, Certified Community Behavioral Health Clinics (“CCBHCs”) have received a short-term funding extension with Congress’ last-minute passage of a temporary government-wide spending bill. Funding for CCBHCs in this extension runs through December 20, 2019. This measure was signed into law late on November 21, just in the nick of time as... READ MORE

On May 1, 2019, the Michigan Medical Service Administration of the Michigan Department of Health & Human Services (“MDHHS”) issued Bulletin MSA 19-10 (the “Bulletin”), which set forth new enrollment and billing requirements for nurse practitioners (“NPs”) and clinical nurse specialists (“CNSs”) participating in the Michigan Medicaid program. Under the new guidelines, effective June... READ MORE

Congressional Leaders Discuss Health Care Priorities Congress’ top leaders, Senate Majority Leader Mitch McConnell (R-KY) and House Speaker Nancy Pelosi (D-CA), announced they are not embracing “Medicare for All” as a priority at the American Hospital Association’s annual Washington conference. Both leaders reinforced that each chamber will pursue largely separate health care agendas in... READ MORE