Blog

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.

This is the image text
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”)…
Oregon's New Waiver Request to Exclude Accelerated Approval Drugs from Medicaid Coverage
Blog March 01, 2022
Hello readers! Today's post focuses on a topic we've touched on a few times in the past – Medicaid drug formularies. Back in December 2021, the state of Oregon released a draft Medicaid waiver proposal that caught the attention of many stakeholders. In the draft proposal, Oregon stated that it was considering asking CMS for approval to a) adopt a commercial-style closed drug formulary and b) exclude from Medicaid coverage certain drugs approved via the accelerated approval pathway “with…
Massachusetts Medicaid Proposes Changes to Hospital Acquisition of Costly Prescription Drugs
Blog December 10, 2019
Earlier this year, we wrote about a lawsuit involving the 340B drug pricing program.  We sometimes write about the 340B program because  it is integrally linked to the Medicaid prescription drug rebate program.  So today, we wanted to call attention to a proposed regulation issued by the Massachusetts Medicaid program (which is called “MassHealth”) that shows that link clearly. Section 1927 of the Social Security Act requires pharmaceutical manufacturers to provide a rebate to state Medicaid…
Robbing Peter to Pay Paul:  Problems in Enforcing the Medicaid Secondary Payer Requirements
Blog May 23, 2019
One of the things that gets drummed into your head working with Medicaid is this:  Medicaid is a payer of last resort.  Medicaid can only pay for a health care service when there is no other payer available.  If a Medicaid beneficiary has virtually any other source of health insurance coverage, that coverage pays first. This requirement is set forth in the basic rules of the Medicaid program…
Massachusetts House Pushes Medicaid Supplemental Rebate Law in Budget
Blog April 16, 2019
On April 11, 2019, the Massachusetts House Committee on Ways and Means released its FY 2020 budget (H.3800).  The legislation includes provisions authorizing MassHealth (the Massachusetts Medicaid program) to negotiate supplemental rebates directly with drug manufacturers, and provides for further proceedings before the Health Policy Commission for manufacturers refusing to negotiate supplemental rebates at levels satisfactory to the Commonwealth. These provisions represent amendments to a…

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