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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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Averting a Medicaid Coverage Cliff: CMS's Continuous Enrollment Unwinding Guidance
Blog June 09, 2022
Bracing for the inevitable end of the COVID-19 Public Health Emergency (PHE), CMS has begun issuing voluminous guidance to states on unwinding Medicaid's continuous enrollment requirement without precipitating a calamitous drop in coverage. We've previously discussed the continuous enrollment requirement here, here and here. By way of background, section 6008 of the Families First Coronavirus Response Act (FFCRA)…
President Biden Takes First Step Towards Reversing Trump Era Medicaid Policies
Blog January 29, 2021
On January 28th, President Biden issued an “Executive Order on Strengthening Medicaid and the Affordable Care Act.” The E.O. states that the Biden Administration will promote policies that “protect and strengthen Medicaid and the ACA and … make high-quality healthcare accessible and affordable for every American.” To this end, the E.O. makes several important policy changes, including asking the HHS Secretary to establish a Special Enrollment Period for the ACA marketplace…
CMS Approves Tennessee Block Grant Waiver: A Summary and Analysis from your Editors
Blog January 11, 2021
For our discussion of the new closed formulary flexibility approved in Tennessee, you can read our follow-up post here.  Introduction On Friday January 8th, in the final days of the Trump Administration, CMS announced approval of a first-in-the-nation waiver that would permit Tennessee to transition from Medicaid's longstanding, open-ended financing model to a modified “block grant”…
States Can Now Keep Enhanced COVID-19 Match, Make Coverage and Benefit Changes
Blog October 30, 2020
Back in March, Tom gave you, our readers, an overview of the Administrations and Congress initial response to the COVID-19 pandemic, including the inclusion in the second Congressional package (the Families First Coronavirus Response Act) of a substantial bump to each state Medicaid program's federal medical assistance percentage (FMAP) during the period of the current national emergency to the extent they abide by certain minimum standards…
CMS Releases Block Grant Guidance: Answers to your FAQs
Blog February 04, 2020
On January 30, 2020, the Centers for Medicare Medicaid Services (CMS) issued its long awaited and highly anticipated State Medicaid Director Letter (SMD Letter) announcing the “Healthy Adult Opportunity” (HAO) initiative that will allow states to carry out demonstrations to implement either an aggregate or per-capita cap financing model for certain Medicaid populations.  Weve previously previewed and highlighted some of the key expectations for this long-awaited guidance…
Ten Things to Watch for in the Forthcoming Block Grant Guidance (UPDATED)
Blog January 28, 2020
UPDATED: It's out! The much anticipated guidance, entitled the “Healthy Adult Opportunity” (HAO), from CMS introducing ways to revamp Medicaid financing has been out for nearly a week and we have had some time to review the guidance in more detail. Weve update our questions below with answers based on our review of the guidance document. As previously reported here on the blog…
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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