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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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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…
Ten Things to Watch for in the Forthcoming Block Grant Guidance (UPDATED)
Blog January 28, 2020
UPDATED: It's out! The much anticipated guidance, entitled the “Healthy Adult Opportunity” (HAO), from CMS introducing ways to revamp Medicaid financing has been out for nearly a week and we have had some time to review the guidance in more detail. Weve update our questions below with answers based on our review of the guidance document. As previously reported here on the blog…
CMS to Phase Out Designated State Health Program (DSHP) Funding
Blog February 01, 2018
On December 15, 2017, CMS Director Brian Neale informed State Medicaid Directors of CMS' intent to phase out funding for Designated State Health Programs (DSHP) in Section 1115 waivers.  CMS will no longer approve waiver requests under Section 1115 for DSHP funding, and will not renew portions of existing waivers that provide DSHP funding. DSHP funding in Section 1115 waivers developed alongside of CMS' funding of Delivery System Reform Incentive Payments (“DSRIP”)…
Partner Tom Barker Discusses Gov. Bakers Bipartisan Approach to Health Care Reform with WBUR
Blog September 08, 2017
Gov. Charlie Baker testified with four other governors on Capitol Hill in the latest sign that hes playing a role in the next phase of federal health care reform. Partner Tom Barker speaks with WBUR about Bakers proposal to change the way Massachusetts covers some low-income individuals, and how this could garner national attention. Click here to read the article…
Massachusetts Proposes to Dramatically Restructure Medicaid Benefits
Blog July 21, 2017
On July 21, 2017, the Massachusetts Executive Office of Health and Human Services (EOHHS) announced its intent to submit a request to amend its existing MassHealth Section 1115 Demonstration to the Centers for Medicare and Medicaid Services (CMS).   If approved (by both the State legislature, and CMS), it would be the most sweeping change to any states Medicaid pharmacy benefit to date. We previously previewed some of the changes EOHHS was considering under the new flexibility granted to…
New Massachusetts Employer Assessment Intended to Deter MassHealth Enrollment
Blog July 11, 2017
Since the beginning of this year's legislative session, Governor Baker has expressed concern over the growth in enrollment in MassHealth, the state's Medicaid program. A look at the numbers explains why. Prior to the enactment of the Affordable Care Act's Medicaid expansion in 2014, there were 1.3 million people enrolled in MassHealth. By April of this year, that number had increased by 28.4%, to nearly 1.7 million state residents…
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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