Program Details
2026-09-22 13:00:00
Over 1,000+ webinars
Course Overview
2026-09-22 13:00:00
2h CLE Credits
Intermediate
2
1:00 pm - 2:00 pm ESTThis session traces the medical frailty exemption from its statutory baseline in OBBBA (H.R. 1) § 71119, Pub. L. No. 119-21, and 42 U.S.C. § 1396a(xx)(9)(A)(ii)(V), through the 2013 Alternative Benefit Plan framework at 42 C.F.R. § 440.315(f), to the points at which CMS’s interim final rule departs from both. It covers the new “significantly impairs … community engagement” requirement at 42 C.F.R. § 435.554(c)(5)(i), the 12-month cap on the claims and encounter data states may rely on, and the narrowing of self-attestation beginning January 1, 2028. It then works category by category through what the record must show for each of the five statutory categories, including the five-year “stable recovery” carve-out for substance use disorder, and closes with a current read on Commonwealth of Massachusetts et al. v. Oz et al., No. 1:26-cv-12962 (D. Mass.), where the states’ motion for a preliminary injunction was denied without prejudice on July 29–30, 2026 and expedited summary judgment briefing is expected to resolve before enforcement begins January 1, 2027.
Kevin J. MaloneDavid Shillcutt 2:10 pm - 3:10 pm ESTThe CMS interim final rule on Medicaid community engagement requirements puts every state on the clock for a January 1, 2027 implementation deadline, and disabled and chronically ill clients who don’t clear the rule’s narrowed “significantly impairs” medical frailty standard still have several routes to keep coverage. This session moves past frailty documentation to the rest of the compliance architecture: the other statutory options for compliance, exceptions and exclusions, the verification processes, and the notice requirements and noncompliance processes. It also covers where litigation stands after the court declined to block the rollout in Massachusetts v. Oz, and what practitioners should be doing in the months before their state switches enforcement on.
Leonardo CuelloLeonardo Cuello is a Research Professor at the Georgetown University McCourt School of Public Policy’s Center for Children and Families, where his work centers on Medicaid law and policy — Medicaid and Marketplace waiver authority, Medicaid managed care, Medicaid expansion, benefit packages, payment and delivery system reform, and health-related social needs. Across two decades in the field he has been involved in many of the major Medicaid issues and litigation of recent times, work requirements among them.
Kevin J. Malone is a Member of the Firm at Epstein Becker & Green, P.C. in Washington, DC, and a Strategic Advisor with EBG Advisors. He led the federal implementation of the 2013 Alternative Benefit Plan rollout at CMCS — the framework from which the medically frail standard descends — and his practice today covers health policy and legislation, managed care, behavioral health, mental health parity, and government and commercial coding, coverage, and payment for health plans, provider organizations, states, and trade associations.
David Shillcutt is a Member of the Firm at Epstein Becker & Green, P.C. in Washington, DC. He came to private practice from the Centers for Medicare & Medicaid Services, where he served as a Health Insurance Specialist in the Medicaid Division of Managed Care Plans, and his practice covers behavioral health, managed care, health policy and legislation, government and commercial coding, coverage, and payment, mental health parity, and privacy compliance strategies.
Leonardo Cuello is a Research Professor at the Georgetown University McCourt School of Public Policy’s Center for Children and Families, where his work centers on Medicaid law and policy — Medicaid and Marketplace waiver authority, Medicaid managed care, Medicaid expansion, benefit packages, payment and delivery system reform, and health-related social needs. Across two decades in the field he has been involved in many of the major Medicaid issues and litigation of recent times, work requirements among them.
Kevin J. Malone is a Member of the Firm at Epstein Becker & Green, P.C. in Washington, DC, and a Strategic Advisor with EBG Advisors. He led the federal implementation of the 2013 Alternative Benefit Plan rollout at CMCS — the framework from which the medically frail standard descends — and his practice today covers health policy and legislation, managed care, behavioral health, mental health parity, and government and commercial coding, coverage, and payment for health plans, provider organizations, states, and trade associations.
David Shillcutt is a Member of the Firm at Epstein Becker & Green, P.C. in Washington, DC. He came to private practice from the Centers for Medicare & Medicaid Services, where he served as a Health Insurance Specialist in the Medicaid Division of Managed Care Plans, and his practice covers behavioral health, managed care, health policy and legislation, government and commercial coding, coverage, and payment, mental health parity, and privacy compliance strategies.
Requirements
The Alabama State Bar MCLE Commission requires attorneys to complete 12 credits, including 1 ethics, by December 31 of each year. All credits must be reported by February 15 of the following year. A maximum of 12 credits, including 1 ethics credit, may be carried over for 1 year only.
Formats
