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Long Awaited Approval of the 1115 Waiver Amendment for NYS Medicaid – Just in Time for the New York State Executive Budget State Fiscal Year (SFY) 2025

Health Care Law Brief

FEBRUARY 2, 2024

While still subject to legislative approval, the Executive Budget incorporates the recently approved amendment (“Waiver Amendment”) to New York’s Medicaid Section 1115 Demonstration that includes $7.5 billion in Medicaid investments over the next three years. Services will be delivered via a two-tiered system.

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Medicaid Medicaid Medicare Medicare 52
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CMS Begins Option to Extend Medicaid Postpartum Coverage

Healthcare Law Blog

APRIL 6, 2022

On April 1, 2022 , the Centers for Medicare & Medicaid Services (“CMS”) announced states may seek to extend Medicaid postpartum coverage from 60 days to one year through a new state plan option offered by the American Rescue Plan Act (“ARPA”). This option is available for five years and ends on March 31, 2027.

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Medicaid Medicaid ACA Public Health 52
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CMS Imposes New Requirements on Payers to Improve Prior Authorization Process and Payer, Patient and Provider Communications

Hall Render

MARCH 20, 2024

The improved information requirements apply to the following payers, including: Medicare Advantage plans; Medicaid and Children’s Health Insurance Program (“CHIP”) managed care plans; State Medicaid and CHIP fee-for-service payers; and Qualified Health Plans only in the Federally Facilitated Exchanges.

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CMS Finalizes its Proposal to Advance Interoperability and Improve Prior Authorization Processes

Healthcare Law Blog

JANUARY 26, 2024

On December 13, 2022, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule, titled Advancing Interoperability and Improving Prior Authorization Processes (“Proposed Rule”), to improve patient and provider access to health information and streamline processes related to prior authorizations for medical items and services.

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US Department of Health and Human Services Medicare Medicare Medicaid 52
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Consumers and Cancer: 3 Patient-Focused Charts From IQVIA on the State of the Oncology in 2023

Jane Sarashon

JUNE 5, 2023

Just in time for #ASCO2023, the IQVIA Institute published their annual report on Global Oncology Trends 2023 – Outlook to 2027 , an update featuring pipelines, therapy approvals, research updates, costs of oncology products, and patients. in 2023, and millions of more people worldwide.

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Medicaid Medicaid COVID-19 Health Insurance 52
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Wasted: $1 of Every $4 Spent on Health Care In America

Health Populi

OCTOBER 8, 2019

The Centers for Medicare and Medicaid Services (CMS) forecasts that prescription drug spending will be the fastest-growing cause of rising health spending by 2027. That’s the Holy Grail and vision in my book, HealthConsuming: From Health Consumer to Health Citizen.

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Prescription Drug Pricing Medicare Medicare ACA 108
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Healthcare Reforms Under the IRA: Expanding Access to Care

Healthcare Law Blog

AUGUST 25, 2022

Fifteen more Part D drugs are set to be published in 2027, followed by 15 Part D and Part B drugs, collectively, in 2028. The IRA includes a three-year extension of enhanced financial assistance for people enrolled in health insurance through the marketplaces under the Affordable Care Act. Negotiation-Eligible Drugs.

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Medicare Medicare Medicaid Medicaid 52
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