Public Programs

State governments respond to the ever-changing needs of the population by creating new programs or modifying existing ones. The goal of the program may be far-reaching or relatively modest, but a similar set of tasks is required for success. The Center for Health Law and Economics at UMass Medical School helps ensure that those tasks are completed. Our services for designing and implementing public programs include the following:

  • Identifying systems of service delivery
  • Recommending eligibility requirements
  • Advising on choosing and obtaining services and providers
  • Identifying which agencies should be implementing the program, including a lead agency
  • Defining roles and responsibilities for each agency
  • Structuring and implementing incentives for providers and program clients
  • Recommending potential changes to regulations
  • Monitoring, evaluating, and recommending improvements to the program

Medicaid/CHIP

As states’ primary means for extending health care coverage to their most vulnerable residents, Medicaid and the Children’s Health Insurance Program (CHIP) often make up the foundation of state health reform initiatives. These complex programs, governed by overlapping layers of federal and state laws and regulations, can also bring federal financial resources to states. Our staff keeps up-to-date on the federal and state regulations and understands that every modification has the potential to affect new and existing health care policies and programs. As health lawyers, our team leaders have the necessary experience to anlayze and intrepret the statutory and regulatory provisions of Medicaid and CHIP and we assess the following for our clients:

  • The financial and coverage impacts of new or proposed Medicaid and CHIP rules on public programs or policies
  • Whether new policies or programs are in compliance with Medicaid and CHIP rules
  • The impact of related federal laws on existing Medicaid and CHIP programs
  • Role of Medicaid and CHIP in broader reform efforts

Further flexibility in Medicaid and CHIP is available through State Plan amendments and the federal waiver process. Our long experience conceiving and drafting State Plan amendments and federal waivers has educated us on their tremendous potential — and their pitfalls. This experience, along with our deep understanding of the legal and financial aspects of the waiver process, enables us to guide our clients through the process