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Medicaid & the Law

Legal, regulatory and strategic advice regarding America's largest health insurance payer, and one of the most complicated and least understood areas of healthcare law.

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Medina v. Planned Parenthood South Atlantic: Oral Arguments Focus on Statutory ‘Magic Words’
Blog April 09, 2025
On April 2, 2025, the U.S. Supreme Court heard oral arguments in Medina v. Planned Parenthood South Atlantic. At issue in Medina is § 1902(a)(23) of the Social Security Act (the Act),1 or the “free-choice-of-provider” provision, which allows Medicaid beneficiaries to seek care from any qualified provider…
Oregon's New Waiver Request to Exclude Accelerated Approval Drugs from Medicaid Coverage
Blog March 01, 2022
Hello readers! Today's post focuses on a topic we've touched on a few times in the past – Medicaid drug formularies. Back in December 2021, the state of Oregon released a draft Medicaid waiver proposal that caught the attention of many stakeholders. In the draft proposal, Oregon stated that it was considering asking CMS for approval to a) adopt a commercial-style closed drug formulary and b) exclude from Medicaid coverage certain drugs approved via the accelerated approval pathway “with…
Georgia Files Suit Against CMS for “Regulatory Bait and Switch” Over its Expansion Population
Blog February 02, 2022
Before jumping into the latest litigation over Medicaid waivers, Medicaid and the Law would like to introduce its readers to Adam Schilt. Adam is a healthcare associate in the Washington, DC office and will be a regular contributor to the blog. In a past role, he's written pieces of legislation that have been enacted into the Medicaid statute and continues to be very passionate about the subject…
Justice Breyer's Influence on America's Health Care System
Blog February 01, 2022
This week's news that Justice Stephen Breyer would step down from the Supreme Court at the conclusion of the Court's term definitely caught our attention here at the Medicaid and the Law Blog.  Our view is that Justice Breyer – who, for whatever reason, did not get a significant amount of attention from the mainstream media – had a monumental influence on the American health care system…
Renewed Focus on Medicaid Home and Community-Based Services
Blog May 26, 2021
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…
Advocates File Suit Over Tennessee Waiver  Dissecting the Complaint
Blog April 23, 2021
On April 22, 2021 the Tennessee Justice Center and the National Health Law Program, representing thirteen (13) aggrieved Medicaid beneficiaries in the state of Tennessee, filed suit in the U.S. District Court for the District of Columbia against the U.S. Department of Health and Human Services (HHS) seeking to block the implementation of the TennCare III modified block grant 1115 waiver approved in the waning days of the Trump Administration…
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Blog Editors

About Our Blog

Foley Hoag has a unique team of healthcare lawyers and specialists with decades of experience in statutory and regulatory analysis, compliance, government investigations, litigation and corporate transactions. Most of our lawyers and healthcare policy specialists have had a direct hand in shaping virtually every healthcare law and regulation enacted over the past four decades, including:

  • The Patient Protection and Affordable Care Act of 2010
  • The Medicare Modernization Act of 2003
  • The Food and Drug Administration Modernization Act of 1997
  • The Balanced Budget Act of 1997
  • The Health Insurance Portability and Accountability Act of 1996 (HIPAA)
  • Budget reconciliation laws of the 1980s

Medicaid is also, by far, the largest health insurance payer in the United States and has even surpassed Medicare in terms of the number of enrollees. Medicaid is a crucial component in America’s health care system.


Our focus includes:

  • Medicaid coverage and reimbursement issues for innovative pharmaceutical products
  • Legal, regulatory and strategic advice for Medicaid mental health providers and payers
  • Medicaid waivers
  • State coverage of the Medicaid expansion population
  • State-specific Medicaid issues
  • Medicaid financing
  • Medicaid and long-term care

Blog Editors