News & Analysis as of

DSH Medicaid

King & Spalding

CMS Issues IPPS and LTCH PPS Final Rule for FY 2024

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On August 1, 2023, CMS issued its annual Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule for FY 2024 (the Final Rule). In the Final Rule, CMS,...more

ArentFox Schiff

Drastic Scheduled Cuts to Disproportionate Share Hospital Funding Would Increase Financial Distress for Safety Net Hospitals

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Over 2500 hospitals across the country historically have relied upon Disproportionate Share Hospital (DSH) Medicaid payments for financial stability. These DSH payments, made in large measure to hospitals with high Medicaid...more

McDermott Will & Emery

Proposed Changes to DSH Payment Calculation Regulations Could Impact 340B Hospitals

McDermott Will & Emery on

On February 28, 2023, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule that would change how Medicare disproportionate share hospital (DSH) payments are calculated with respect to the counting of...more

King & Spalding

CMS Proposes for the Third Time to Exclude Section 1115 Uncompensated Care Pool Days from Medicare DSH

King & Spalding on

On February 24, 2023, CMS issued a proposed rule that would modify the Medicare Disproportionate Share Hospital (DSH) payment regulation to limit the universe of Section 1115 demonstration beneficiaries who can be “regarded...more

Holland & Knight LLP

Supreme Court Backs Rule That Decreases Medicare Payments to Safety-Net Hospitals

Holland & Knight LLP on

The U.S. Supreme Court settled an Administrative Procedures Act (APA) dispute on June 24, 2022, involving Medicare's formula to adjust rates paid to safety-net hospitals, clarifying a statute that dictates how to calculate...more

McDermott Will & Emery

Hospital Reimbursement Opportunity Remains After CMS Decides Not to Finalize DSH Payment Calculation Changes

McDermott Will & Emery on

On December 17, 2021, the Centers for Medicare & Medicaid Services (CMS) released the fiscal year (FY) 2022 inpatient prospective payment system (IPPS) final rule. In light of the significant volume of comments, CMS declined...more

Lathrop GPM

U.S. Supreme Court Hears Oral Arguments in Two Hospital Cases This Week

Lathrop GPM on

This is a big legal week for hospitals and health systems as the U.S. Supreme Court heard not one, but TWO different oral arguments related to federal government payments to hospitals and health systems. In both cases, the...more

Foley Hoag LLP - Medicaid and the Law

Supreme Court Will Hear Several Health Care Cases in 2022 Term

Recently, my colleague Regina DeSantis told you about the ongoing saga involving disputes between 340B contract pharmacies and pharmaceutical manufacturers.  We often write about the 340B program on our blog because of the...more

McDermott Will & Emery

[Webinar] 340B… Or Not 340B: Oversight, Compliance and Enforcement - July 15th, 9:00 am - 10:00 am PT

McDermott Will & Emery on

The 340B Program has gained national attention over the last decade, in part due to the opportunities it provides to generate revenue for participating entities without risk of significant enforcement penalties for...more

Sheppard Mullin Richter & Hampton LLP

Another Win for Hospitals: Courts Reject HHS’ Attempt to Narrow DSH Payment Calculations

On November 13, 2020, the D.C. Court of Appeals upheld a key ruling regarding disproportionate share hospital (“DSH”) payments, in Bethesda Health Inc. v. Azar, a significant victory for hospitals. Hospitals that treat a...more

ArentFox Schiff

CMS Withdraws Proposed Medicaid Fiscal Accountability Regulation

ArentFox Schiff on

The Centers for Medicare and Medicaid Services (CMS) has withdrawn its proposed Medicaid Fiscal Accountability Regulation (MFAR), according to a September 14, 2020, announcement via Twitter by Administrator Seema Verma. ...more

King & Spalding

CMS Issues Medicare IPPS and LTCH Final Rule for FY 2021

King & Spalding on

On September 2, 2020, CMS issued the fiscal year (FY) 2021 final rule for the hospital inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective payment system (the Final Rule). This article...more

Foley Hoag LLP - Medicaid and the Law

A Loss in SCOTUS Prompts New CMS Notice of Proposed Rulemaking

On August 4th, CMS released a proposed rule titled Treatment of Medicare Part C Days in the Calculation of a Hospital’s Medicare Disproportionate Patient Percentage (DPP). We’ve written before about the Medicaid...more

King & Spalding

CMS Releases FY 2021 Medicare IPPS and LTCH PPS Proposed Rule

King & Spalding on

On May 11, 2020, CMS issued its annual Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System Proposed Rule for FY 2021 (the Proposed Rule), which will affect...more

K&L Gates LLP

K&L Gates Triage: 340B Update - Hospitals Request Eligibility Flexibilities Amid COVID-19 Pandemic

K&L Gates LLP on

In this episode, Richard Church and Victoria Hamscho discuss recent developments in the 340B Drug Pricing Program, including recent COVID-19 guidance by the Health Resources and Services Administration and hospital requests...more

ArentFox Schiff

CMS Proposes Increased Scrutiny of Medicaid Supplemental Payments and Related State Financing Arrangements

ArentFox Schiff on

In what is widely considered to signal intensified focus by the Federal government on Medicaid supplemental payments and related State Medicaid financing mechanisms, the Centers for Medicare & Medicaid Services (CMS) on...more

Foley Hoag LLP - Medicaid and the Law

D.C. Circuit Reverses District Court in DSH Case

We have long covered the handful of lawsuits that have been filed over the past several years concerning Medicaid disproportionate share hospital (“DSH”) payment policies. These lawsuits all revolve around some steps that CMS...more

King & Spalding

D.C. District Court Issues Favorable Decision in Section 1115 Waiver DSH Case

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On September 28, 2018, the United States District Court for the District of Columbia issued a favorable decision for hospitals appealing the CMS Administrator’s disallowance of certain Medicaid section 1115 waiver days from...more

King & Spalding

New Hampshire Hospital Association v. Azar is Another Win for Hospitals in Medicaid DSH Reimbursement Litigation

King & Spalding on

On August 25, 2018, the U.S. District Court for the District of New Hampshire in New Hampshire Hospital Association v. Azar gavehospitals another victory in their claims that CMS unlawfully reduces Medicaid Disproportionate...more

King & Spalding

First Circuit Rejects CMS FAQs Clarifying Medicaid DSH Payment Calculations

King & Spalding on

On April 4, 2018, the United States Court of Appeals for the First Circuit affirmed a district court ruling that rejected CMS’s enforcement of two FAQs that clarified how certain reimbursements made to hospitals for...more

Mintz - Health Care Viewpoints

Disproportionate Share Hospital Payments: A Minibus Rider

As a part of our ongoing blog series we have provided details on the structure, funding, and outlook of several expiring health care provisions, that we’ve referred to as the health care minibus. The minibus includes all of...more

BakerHostetler

CMS Digging In on Medicaid DSH Payments

BakerHostetler on

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

King & Spalding

CMS Issues IPPS and LTCH PPS Final Rule for FY 2018

King & Spalding on

On August 2, 2017, CMS issued the Fiscal Year (FY) 2018 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) Prospective Payment System Final Rule (Final Rule) that updates...more

Holland & Knight LLP

Healthcare Legislation Outlook and Update

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

Manatt, Phelps & Phillips, LLP

What Could Reconciliation Mean for Medicaid: Reviewing HR 3762

President-elect Trump and leaders in Congress have proposed a major restructuring of the Medicaid program, but very significant changes to Medicaid coverage and financing could be adopted even before that debate begins as...more

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