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Disproportionate Share Adjustments Centers for Medicare & Medicaid Services (CMS) Medicare Part A

King & Spalding

Ninth Circuit’s Unanimous Decision in Favor of Empire Health Foundation Vacating Medicare’s 2005 Disproportionate Share Regulation...

King & Spalding on

On October 28, 2020, after previously denying the Secretary of Health and Human Services’ (HHS) request for en banc review, the Ninth Circuit issued a mandate rendering effective its unanimous panel decision on behalf of...more

King & Spalding

Supreme Court Delivers Victory to Providers in Allina DSH Part C Case in a Decision with Broad Implications

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In a major win for providers that serve a disproportionate share of indigent patients, the Supreme Court today upheld the D.C. Circuit’s earlier decision invalidating CMS’s policy to treat beneficiaries enrolled in Part C...more

Baker Donelson

CMS Issues Instructions to Hospitals Regarding the Implementation of Ruling 1498-R2

Baker Donelson on

In April 2015, CMS issued Ruling 1498-R2 addressing the calculation of the Medicare fraction of the disproportionate share hospital (DSH) adjustment for patient discharges prior to October 1, 2004. CMS has now issued...more

King & Spalding

HHS Wins Summary Judgment Against Hospitals Disputing CMS’s Treatment of Part C Days as Days “Entitled to Part A” for Purposes of...

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On August 17, 2016 the United States District Court for the District of Columbia granted summary judgment in favor of HHS in a dispute over whether Part C days can be treated as “days entitled to benefits under Part A” for...more

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