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
Gang of Six Introduces Historic 340B “Discussion Draft” Legislation
BlogFebruary 07, 2024
On February 2, 2024, the “gang of six”—a bipartisan group of six senators who have traditionally championed reforms to the 340B program —introduced a discussion draft of a bill that would modify the program that provides safety net providers with access to low-cost medications from participating manufacturers. The 340B statute has not been modified since 2010…
CMS Issues Rule Implementing Medicaid Redetermination Policies
BlogDecember 11, 2023
We’ve written recently about the process that states are undertaking to begin to wind down the Medicaid enrollment expansion that was necessitated by the enactment of the Families First Coronavirus Response Act in March of 2020. Readers of our blog may recall that…
State Medicaid Redeterminations Following the End of the COVID-19 Era Continuous Enrollment Requirement
BlogSeptember 18, 2023
At the onset of the COVID pandemic in March of 2020, Congress made an important policy decision: continued access to health coverage was crucial, especially because, at the time, it was uncertain how the economy would respond to the shutdowns that public health officials felt were necessitated by the pandemic…
CMMI Introduces New Multi-State Initiative Focused on Enhancing Primary Care Delivery
BlogJune 12, 2023
CMMI was established to test innovative payment and service delivery models expected to reduce expenditures and preserve or enhance care quality under Medicare, Medicaid, and the Children’s Health Insurance Program. Over the last decade, CMMI has tested a variety of models, including several primary care models…
The Supreme Court’s Talevski Decision: Medicaid Private Enforcement under Section 1983 Lives to See Another Day
BlogJune 12, 2023
Today’s post provides an important update on the Supreme Court case Health & Hospital Corporation of Marion County (HHC) v. Talevski.As readers will remember, our blog has been following this case since it made its way to the Supreme Court…
CMMI Describes Progress on Addressing Health Equity
BlogMay 15, 2023
In October of 2021, the Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (CMMI) unveiled its 2030 vision to achieve “equitable outcomes through high quality, affordable, and person-centered care.” One of the objectives to achieve this goal is to focus on “advancing health equity.”…
1 of 32

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

Related Services

Our fluency in healthcare laws and policy helps us to help our clients develop successful strategies for navigating the complex health care environment. Learn more about our practices and focus areas within the healthcare industry:

We keep clients ahead of the shifts and out of the gray areas with an approach built on a deep understanding of healthcare law and a strong tradition of developing innovative legal solutions
We help healthcare providers achieve their business and strategic goals when it comes to their participation in the Medicare and Medicaid programs and in the commercial insurance market
We advise leading companies across the digital health spectrum, from disease diagnostics, to digital treatment therapeutics, to tech-driven health insurance platforms
We provide the innovative counsel and constant diligence that companies need to bring products to market and have a voice in regulatory processes
Our skilled Healthcare Regulatory team is advising clients on implementation of the historic Medicare drug price negotiation and new drug pricing policy changes passed as part of the Inflation Reduction Act of 2022
We advise early stage to global leaders of drug, biological and medical device companies on a broad range of health policy matters impacting novel technologies with a particular expertise on Medicare coverage, coding and payment determinations.
We’ll help protect your interests in commercial litigation and civil disputes, internal investigations and enforcement actions
We help Medicare Advantage and Part D plans, Medicaid managed care plans, pharmacy benefit managers, and commercial insurers navigate the complex U.S. healthcare system
Our healthcare and life sciences regulatory team regularly interfaces with state and local government agencies on a wide variety of legislative and regulatory matters affecting the life sciences