Newsletters

06.25.15

SCOTUS Upholds Subsidies in King v. Burwell: A Look at the Ruling and Its Implications

In a 6-3 decision today, the Supreme Court ruled that individuals who enroll in health insurance through the federally facilitated marketplace (FFM) may continue to receive federal tax subsidies to help pay for their coverage.


06.23.15

Manatt on Health Reform: Weekly Highlights, June 23, 2015

This week...no clear consensus has emerged among congressional Republicans on how to manage potential King v. Burwell fallout; California will expand Medicaid to undocumented children; and New York is poised to become the first state to establish pregnancy as a qualifying event for Marketplace ...


06.22.15

Examining Fee Splitting Statutes in the Context of Value-Based Healthcare

Fee splitting prohibitions are aimed primarily at situations where a healthcare professional, in order to generate patient referrals from other licensed or unlicensed persons, splits part of the professional fee earned from treating the referred patient with the source of the referral.


06.18.15

New Analysis of Delivery System Reform Incentive Payment Waivers—Early Results and Issues to Watch

Introduced originally in California and followed by Texas, Massachusetts, New Jersey, Kansas and New York, Delivery System Reform Incentive Payment or DSRIP programs are a key feature of the dynamic and evolving Medicaid delivery system reform landscape.


06.16.15

Manatt on Health Reform: Weekly Highlights, June 16, 2015

With the King v. Burwell ruling expected by the end of the month, Congressional Republicans continue to offer contingency plans in the event of a ruling for the plaintiffs; and the Mississippi Insurance Commissioner proposes a state-specific plan.


06.11.15

CMS Proposes Overhaul of Medicaid and CHIP Managed Care Rules

On May 26, 2015, the Centers for Medicare and Medicaid Services (CMS) released a notice of proposed rulemaking (NPRM) to overhaul the regulations governing Medicaid managed care and make conforming changes to the rules that govern the state Children’s Health Insurance Program (CHIP).


06.09.15

Manatt on Health Reform: Weekly Highlights, June 9, 2015

With an eye toward the imminent King v. Burwell ruling, Delaware submits a Supported State-based Marketplace blueprint to CMS and South Carolina’s governor says the State will not establish a State-based Marketplace.


06.02.15

Manatt on Health Reform: Weekly Highlights, June 2, 2015

States continue to prepare for a potential decision adverse to the government in King v. Burwell, with Pennsylvania submitting an application to be a supported State-based Marketplace; CMS releases information reflecting wide variation in proposed 2016 premium increases from insurers in the ...


05.27.15

Manatt on Health Reform: Weekly Highlights, May 27, 2015

CMS proposes a new rule to modernize Medicaid and CHIP managed care; the Florida saga continues with CMS proposing to extend—and reduce—LIP funding; and California's Marketplace approves a co-pay cap on specialty drugs.


05.20.15

Building a Culture of Health: The Value Proposition of Retail Clinics

Retail clinics offer convenient, low-cost basic primary care treatment, screening and diagnostic services in a variety of settings. Increasingly, these clinics are an integral part of a U.S. healthcare system in the throes of massive change as payers and providers migrate toward the Triple Aim ...