• 03.20.18

    The Promise of Data-Driven Healthcare: Megatrends for 2018

    There is a quote by science fiction writer Amelia Atwater-Rhodes that is the ideal lead-in to any discussion about healthcare data and analytics: “Life is nothing without a little chaos to make it interesting.”

  • 02.21.18

    Hospitals and Health Systems Prepare for a Value-Based Future

    There are six key drivers of the movement to a risk-based healthcare environment:

  • 05.22.17

    A Closer Look at Wisconsin’s Premium Proposal

    The State of Wisconsin recently proposed a Medicaid waiver that includes a number of precedent-setting features, including a 48-month time limit on enrollment (with the limit paused for periods of employment or job training), and mandatory drug screening, testing and treatment (as necessary), as ...

  • 03.23.17

    The Future of Essential Health Benefits

    EHB defines what healthcare benefits plans in the Marketplaces, as well as certain other plans, must cover—and goes to the heart of what it means to have health insurance.

  • 12.19.16

    Balancing Gene Therapy’s Promise and Price

    Gene therapy is the therapeutic delivery of polymers into a patient’s cells for the purpose of treating a disease. Polymers interfere with gene expression or correct mutations.

  • 06.13.16

    CMS Clarifies Medicaid Managed Care Prescription Drug Access

    The recently finalized Medicaid managed care regulations clarify an important point about prescription drug coverage in Medicaid managed care plans. Just as is the case in fee-for-service (FFS) Medicaid, beneficiaries enrolled in Medicaid managed care plans are entitled to any medically necessary ...

  • 12.18.15

    Lessons from Hawaii's Trailblazing ACA 1332 Waiver Proposal

    Section 1332 of the ACA authorizes states to request waivers from the U.S. Department of Health and Human Services (HHS) and U.S. Department of the Treasury of key components of the ACA's coverage provisions.

  • 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 ...

  • 06.11.15

    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).

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