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Kelly Hightower Hibbert

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Kelly Hightower Hibbert is a counsel in Crowell & Moring’s Washington, D.C. office, where she is a member of the firm’s Health Care Group. Kelly focuses her practice on complex commercial litigation before federal and state courts, administrative agencies, and arbitral forums. She is also experienced in defending government investigations involving False Claims Act allegations. In addition to her work as defense counsel, Kelly represents health care clients pursuing recovery of monies lost as a result of fraud, waste, and abuse.

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On November 13, 2020, the Centers for Medicare & Medicaid Services (“CMS”) published a final rule, demonstrating long-awaited efforts to streamline the regulatory framework governing the Medicaid and Children’s Health Insurance Program (“CHIP”) managed care programs.

According to CMS, the purpose of the final rule is to relax certain administrative burdens imposed by the Medicaid managed care rule promulgated by the Obama Administration in 2016. The 2016 rule (the “Mega Reg”), reflecting efforts to modernize the Medicaid and CHIP managed care programs and frustrate widespread fraud and abuse, was the first update to Medicaid managed care regulations in more than a decade.  The following blog post presents a brief summary of the final rule’s key changes.Continue Reading 2020 Medicaid Managed Care Rule Summary