Susan M. Erickson opened the firm in 2015 in Austin, Texas, to provide legal services in such areas as managed care and health insurance regulatory matters, Medicaid managed care, Medicare Advantage plans, and general health care law. Ms. Erickson has nearly 30 years of experience in these areas, gained during many years of practice with the insurance regulatory group of a major international law firm and as in-house general counsel to Texas' largest Medicaid managed care organization. She also spent time as in-house counsel to one of the leading digital health, AI-enabled value-based care companies, where she was lead counsel in drafting and negotiating innovative value-based care contracts with a range of commercial and government-sponsored payors.
May 11, 2023
Covid-19 Public Health Emergency (PHE) Ending.
The national emergency for Covid-19 and the Covid-19 Public Health Emergency end on May 11, 2023, more than three years after they were put in place. Under these emergency declarations, the federal HHS has waived and modified numerous requirements for the Medicare, Medicare Advantage, Medicaid, and CHIP programs. To assist stakeholders in understanding the transition to a post-PHE regulatory environment, CMS issued a FAQ list on Apri 27, 2023.
CMS Issues Notice of Proposed Rulemaking -- Medicaid and CHIP Managed Care Access, Finance and Quality Assurance. In a lengthy notice of proposed rulemaking issued in late April, CMS addresses a wide range of topics in the Medicaid and CHIP programs, including access to care, directed payments, and quality assurance programs. The rule would establish maximum appointment wait time standards for certain Medicaid and CHIP covered services, including routine primary care. It would also require states to submit an annual payment analysis that compares managed care rates for certain services as a proportion of Medicare's payment rate. See here for a CMS Fact Sheet summarizing the rules.
106 Dove Tail Ln.
Georgetown, TX 78628
Health Insurance and Health Plan Regulatory and Transactional Matters
Medicaid Managed Care Law
Medicare Advantage Plans
General Health Care Law