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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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Expanded Protections for Reproductive Health and Gender-Affirming Care: What Massachusetts Providers Need to Know
Blog September 04, 2025
On August 7, 2025, Massachusetts Governor Maura Healey signed into law an Act Strengthening Healthcare Protections in the Commonwealth (the “Act”), which amends the state’s existing “Shield Law” protections for providers of reproductive health and gender-affirming care (“Protected Care”)…
District Courts Issue Key Decisions in 340B Contract Pharmacy Cases
Blog November 09, 2021
Update: On November 10, 2021 Eli Lilly filed a notice of appeal in the case Eli Lilly and Company v. Becerra case challenging the October 29th decision by the Southern District of Indiana. Over the last two weeks we have seen a flurry of activity from U.S. District Courts across the country in the ongoing contract pharmacy disputes between pharmaceutical manufacturers and HRSA…
How Pfizers Warranty Program Gets Around Best Price?
Blog October 14, 2021
On October 13th our friends over at STAT  broke the news [sorry, Paywall] about a warranty pilot program from Pfizer that offers both patients and health plans (including Medicare Part D plans) the opportunity to receive a refund for any amounts paid to purchase the companys longstanding oral lung cancer therapy XALKORI when use is discontinued in the first three months for clinical reasons…
A Deeper Dive into CMS' Multiple Best Prices Policy
Blog January 15, 2021
As my colleague Tom wrote about in a recent post, the Centers for Medicare Medicaid Services (CMS) has finally responded to a growing chorus of stakeholders that government price reporting requirements, particularly Medicaid Best Price (BP), are stifling innovative value-based contracting arrangements (VBAs).  As the proverbial wisdom goes, “nothing changes if nothing changes,” and CMS' recently finalized proposal to allow manufacturers to report multiple BPs is meant to stimulate innovative…
CMS Reneges on Historic Grand Bargain with Manufacturers in Tennessee Wavier Approval
Blog January 12, 2021
If you have not already read it, you can read our main summary of the Tennessee waiver approval HERE. Now that we have had the chance to read and meditate on the historic Medicaid waiver approved on Friday January 8th, giving Tennessee permission from the Federal government to fundamentally alter Medicaids traditional matching financing structure for the 1.5 million Tennesseans who rely on the program for healthcare services…
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”…
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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