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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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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…

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