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Home » Medicaid

Medicaid

Links to Sub-topics:

  • Benefits Enrollment
  • Medicaid Coverage for Drugs and Devices
  • Partial Medicare-Medicaid Duals
  • State Plan Amendment Tracking

Simon&Co. has extensive legislative and regulatory knowledge of the Medicaid program including policies affecting beneficiaries, drug pricing, coverage, and program integrity. We summarize regulations and guidances, with an emphasis on how they impact our clients’ lines of business and advocate for policy changes before Congress and the Centers for Medicare and Medicaid Services (CMS).

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Proposal to Allow State Medicaid Programs to Provide NEMT for Partial Dual Eligibles to Behavioral Health and Substance Use  Disorder Treatment

October 12, 2023
Read moreProposal to Allow State Medicaid Programs to Provide NEMT for Partial Dual Eligibles to Behavioral Health and Substance Use  Disorder Treatment

Proposal to Allow State Medicaid Programs to Provide Home and Community-BasedServices for Partial Medicare-Medicaid Dual Eligibles

October 12, 2023
Read moreProposal to Allow State Medicaid Programs to Provide Home and Community-BasedServices for Partial Medicare-Medicaid Dual Eligibles

New State SPAs Reimburse 340B Covered Entities at Actual Acquisition Cost:  Creates Disincentives For 340B Entities to Choose the Lowest Cost Drugs

October 12, 2023
Read moreNew State SPAs Reimburse 340B Covered Entities at Actual Acquisition Cost:  Creates Disincentives For 340B Entities to Choose the Lowest Cost Drugs

Summary:  Medicaid Program Proposed Rule-Establishing Minimum Standards in Medicaid State Drug Utilization Review and Supporting Value-Based Purchasing for Drugs Covered in Medicaid Revising Medicaid Drug Rebate and Third Party Liability  Requirements

September 18, 2023
Read moreSummary:  Medicaid Program Proposed Rule-Establishing Minimum Standards in Medicaid State Drug Utilization Review and Supporting Value-Based Purchasing for Drugs Covered in Medicaid Revising Medicaid Drug Rebate and Third Party Liability  Requirements

Covered Outpatient Drugs Final Rule, Summary of Major Provisions

September 18, 2023
Read moreCovered Outpatient Drugs Final Rule, Summary of Major Provisions

CMS Awards PR Firm Contract of Up to $19.5 Million for Medicaid Unwinding With No Competition

April 15, 2022
Read moreCMS Awards PR Firm Contract of Up to $19.5 Million for Medicaid Unwinding With No Competition

New State SPA’s Reimburse 340B Covered Entities At Actual Acquisition Cost: Creative Disincentives For 340B Entities To Choose The Lowest Cost Drugs (41 States and DC)

February 11, 2020
Read moreNew State SPA’s Reimburse 340B Covered Entities At Actual Acquisition Cost: Creative Disincentives For 340B Entities To Choose The Lowest Cost Drugs (41 States and DC)

New State SPA’s Reimburse 340B Covered Entities At Actual Acquisition Cost: Creative Disincentives For 340B Entities To Choose The Lowest Cost Drugs (35 States and DC)

October 24, 2018
Read moreNew State SPA’s Reimburse 340B Covered Entities At Actual Acquisition Cost: Creative Disincentives For 340B Entities To Choose The Lowest Cost Drugs (35 States and DC)

Update on SPA Chart

April 20, 2018
Read moreUpdate on SPA Chart

New State SPAs Reimburse 340B Covered Entities at Actual Acquisition Cost: Creates Disincentives For 340B Entities to Choose the Lowest Cost Drugs (31 State SPA’s)

December 26, 2017
Read moreNew State SPAs Reimburse 340B Covered Entities at Actual Acquisition Cost: Creates Disincentives For 340B Entities to Choose the Lowest Cost Drugs (31 State SPA’s)

State SPAs Reimburse 340B Covered Entities at Actual Acquisition Cost (AAC): Creates Disincentives For 340B Entities to Choose the Lowest Cost Drugs

August 21, 2017
Read moreState SPAs Reimburse 340B Covered Entities at Actual Acquisition Cost (AAC): Creates Disincentives For 340B Entities to Choose the Lowest Cost Drugs

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