Susan Feigin Harris on Medicaid

CMS Digging In on Medicaid DSH Payments

During the summer months, several developments have occurred concerning the Medicaid Disproportionate Share Hospital (DSH) policy that the Centers for Medicare & Medicaid Services (CMS) has implemented, to the detriment of a...more

8/30/2017 / Centers for Medicare & Medicaid Services (CMS) , DSH , Hospitals , Medicaid

The Proposed Medicaid DSH Rule: Hospitals, States and Associations Declare It Legally Insufficient

The Centers for Medicare and Medicaid Services (CMS) recently released a proposed rule addressing the treatment of third-party payments when calculating uncompensated care costs for the Medicaid disproportionate share...more

9/23/2016 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Hospitals , Medicaid

Medicaid and CHIP Managed Care Final Rule: It’s All About Consistency

The Centers for Medicare & Medicaid Services (CMS) recently issued a 1,425-page regulation (Rule) on managed care in Medicaid and the Children’s Health Insurance Program (CHIP), dubbed the first overhaul of these regulations...more

5/10/2016 / Centers for Medicare & Medicaid Services (CMS) , Children's Health Insurance Program (CHIP) , Managed Care Contracts , Medicaid , Medical Loss Ratio

Medicaid Managed Care Proposed Rules: The Intersection of Private Insurance and Government Programs

Approximately a quarter of all Medicaid expenditures is spent on the more than half of all beneficiaries (approximately 39 million by 2011 figures cited in the 2014 MACPAC Report) currently accessing part or all of their...more

6/9/2015 / Centers for Medicare & Medicaid Services (CMS) , Children's Health Insurance Program (CHIP) , Health Insurance , MACPAC , Managed Care Contracts , MCOs , Medicaid , Proposed Regulation , Qualified Health Plans , Rulemaking Process

Children’s Hospitals Obtain Temporary Injunction Against CMS

Challenging actions by the Centers for Medicare & Medicaid Services (CMS) under the Administrative Procedures Act (APA), Texas Children’s Hospital and Seattle Children’s Hospital obtained a preliminary injunction that enjoins...more

1/16/2015 / Administrative Procedure Act , Auditors , Centers for Medicare & Medicaid Services (CMS) , Children's Hospital , DSH , Hospitals , Medicaid , Preliminary Injunctions , Reimbursements

Medicaid ACOs: States’ Answer to Escalating Costs?

States increasingly are experimenting with the use of Accountable Care Organizations (ACOs) in their Medicaid programs as a possible avenue to curb the escalating costs of providing care to expanding Medicaid populations....more

10/3/2014 / ACOs , Health Care Providers , Healthcare , Medicaid , Medicare

Academic Medical Centers: Clinical Care, Research and Teaching (or Maybe Not?)—Graduate Medical Education and the Future

In the world of healthcare policy and law, we usually discuss issues impacting providers, but don’t often report about the training and infrastructure behind what allows our healthcare system to treat patients in our...more

8/13/2014 / Affordable Care Act , Centers for Medicare & Medicaid Services (CMS) , Healthcare , Healthcare Reform , Medicaid , Medical Research , Physicians

Five Health Policy Issues to Watch in 2014

As we head into the mid-term election cycle, the ongoing implementation of the Patient Protection and Affordable Care Act (ACA) continues to consume the nation’s healthcare industry and political leaders in 2014. On the...more

5/2/2014 / Affordable Care Act , Centers for Medicare & Medicaid Services (CMS) , Healthcare , Medicaid , Medicaid Expansion , Medicare , Physician SGR Formula

Medicaid DSH: Little-Noticed CMS Rule Interpretation Creates Serious Financial Shortfalls for Impacted Hospitals

In what may have been a largely unnoticed rule interpretation affecting hospitals that treat a high percentage of children in the Medicaid program, CMS, in January 2010, issued a response to a Frequently Asked Question (FAQ)...more

12/17/2013 / Audits , Centers for Medicare & Medicaid Services (CMS) , DSH , Hospitals , Medicaid , Reimbursements , Utilization Calculations

CMS Issues Final Rule Outlining Medicaid DSH Payment Reductions

CMS recently released the final rule confirming its methodology for carrying out reductions to Medicaid disproportionate share hospital (DSH) payments for fiscal year (FY) 2014 and FY 2015. DSH payments, which go to hospitals...more

9/27/2013 / Centers for Medicare & Medicaid Services (CMS) , DSH , Final Rules , Healthcare , Medicaid

The ACA DSH Allotment Reductions: The Balancing Act Between Full Coverage and the Uninsured Continues

As soon as the Supreme Court released its decision regarding the optional nature of the Affordable Care Act's (ACA) Medicaid expansion provision in June 2012, the hospital industry became concerned over the law's imposed...more

6/4/2013 / Affordable Care Act , Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , DSH , Healthcare , Medicaid , Medicaid Expansion , Proposed Regulation

Healthcare Provisions In The American Taxpayer Relief Act - The Good, The Bad And The Ugly

In late night action on December 31, 2012, the American Taxpayer Relief Act of 2012 (ATRA) was passed by the Senate and finalized days later by Congress and the President with a set of tax and spending policy provisions...more

1/15/2013 / Affordable Care Act , American Taxpayer Relief Act , Budget Control Act of 2011 , Co-Op , Disproportionate Share Adjustments , Fiscal Cliff , Healthcare , Medicaid , Medicare , National Institute of Health (NIH) , Spending Cuts

Susan Feigin Harris

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