News & Analysis as of

Disproportionate Share Adjustments Medicaid

Disproportionate Share Hospitals Facing Steep Payment Cuts

While September 30, 2017 has been an important procedural deadline for purposes of the GOP’s most recent legislative push to repeal the Affordable Care Act (ACA), it also serves a critical funding deadline for purposes of the...more

Healthcare Legislation Outlook and Update

by Holland & Knight LLP on

Below is a summary of recent U.S. Senate action on healthcare legislation and our outlook regarding coming issues and possible actions. Holland & Knight's Healthcare & Life Sciences Team will follow up as developments...more

Highlights of Better Care Reconciliation Act

by Holland & Knight LLP on

U.S. Senate Republicans on June 22, 2017, unveiled a "discussion draft" of their healthcare plan, the Better Care Reconciliation Act. This memorandum provides highlights of key provisions. The Congressional Budget Office...more

CMS Clarifies Medicaid DSH Rules for Treatment of Third Party Payments in Calculating Uncompensated Care Costs

by Reed Smith on

CMS has published a final rule intended to codify its existing interpretation of how third-party payments are considered in the calculation of Medicaid uncompensated care costs for the purpose of making Medicaid...more

Draft GOP Affordable Care Act (ACA) Repeal and Replacement Leaked

by King & Spalding on

On Friday, February 24, 2017, Politico released details of a leaked draft House GOP “repeal and replace” bill (Draft) aimed at dismantling key provisions of the ACA, including Medicaid expansion, the individual mandate,...more

Medicaid Supplemental Payments under The American Health Care Act

Currently, state Medicaid programs have flexibility in developing payment policies, including utilizing supplemental payments and non-federal supplemental payment mechanisms. Supplemental payments pay providers above what...more

First Circuit Upholds Exclusion of Dual-Eligible Patients That Are Not Entitled to SSI Benefits from Both the DSH Medicaid...

by King & Spalding on

The U.S. Court of Appeals for the First Circuit recently ruled in favor of HHS, overturning a $17 million district court decision, in a dispute dating back as far as the 1993 fiscal year over whether hospitals may include,...more

D.C. Circuit Precludes Review of DSH Uncompensated Care Data

by Baker Ober Health Law on

On July 26, 2016, the United States Court of Appeals for the District of Columbia Circuit decided Fla. Health Sciences Ctr. v. Burwell. In that case, the Court analyzed a statutory bar against judicial review of estimates...more

CMS Proposes Clarification of Treatment of Third Party Payments in Calculating Uncompensated Care Costs under Medicaid DSH...

by Reed Smith on

CMS has proposed regulatory changes to specify that the hospital-specific limitation on Medicaid disproportionate share hospital (DSH) payments is based on uncompensated care costs net of third-party payments received. Under...more

Manatt on Health Reform: Weekly Highlights - August 2016 #3

CMS’s risk adjustment program data signals an improving risk pool while the agency announces plans to modify the program; California enrolls 134,000 undocumented immigrant children into Medicaid; and Oregon approves increases...more

CMS Releases Final Rule Implementing Reductions of Federal Medicaid DSH Funding

by King & Spalding on

On September 18, CMS published a final rule implementing reductions required by the Affordable Care Act (ACA) for the disproportionate share hospital (DSH) program. The Medicaid DSH program provides federal funding to...more

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

by BakerHostetler on

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

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