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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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CMS Announces new Medicare-Medicaid ACO Model
Blog December 31, 2016
Currently, nearly 10 million Americans are dually-eligible for both Medicare and Medicaid. These dual eligibles are low-income seniors and individuals with disabilities who are separately eligible for and receive coverage under both the Medicare and Medicaid programs.  In general, Medicare acts as the primary payer for dual-eligibles, while Medicaid provides wrap-around coverage for these individuals, helping with some out-of-pocket costs (such as premiums, copayments and deductibles) and…

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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