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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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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…
CMS Begins Internal Purge of Trump-Era Medicaid Policies
Blog February 23, 2021
While CMS has been relatively quiet as of late from a public-facing perspective as it waits for new political leadership to arrive (including newly announced CMS Administrator, Chiquita Brooks-LaSure), a recent review by your Editors at www.MedicandandtheLaw.com of CMS website indicates a fast-paced effort to roll back a number of Trump-era Medicaid policies, particularly around waiver flexibilities. As I recently mentioned…
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”…
Oklahoma releases draft block grant waiver application for public comment
Blog March 16, 2020
We are still reviewing the just-released draft waiver from Oklahoma, but wanted to share with our readers in the meantime. As weve discussed here previously, we expected Oklahoma to be the first-mover after release of the Trump Administrations Health Adult Opportunity guidance in January. You can read the full draft waiver here. Public comments are due April 15…
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…

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