News & Analysis as of

Medicare 1115 Waivers

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

King & Spalding

Florida Hospitals Prevail in D.C. Circuit Appeal Regarding the Exclusion of Low-Income Pool Days from the Medicare...

King & Spalding on

On November 13, 2020, the United States Court of Appeals for the District of Columbia Circuit affirmed a grant of summary judgment to the Florida Hospital Association and ten Florida hospitals represented by King & Spalding...more

Manatt, Phelps & Phillips, LLP

Expanding Payer and Provider Participation in Data Exchange: Options for California

States have struggled for decades to establish infrastructure that allows for the efficient and secure sharing of health information, despite it being associated with improved quality and reduced duplicative services and...more

Manatt, Phelps & Phillips, LLP

Evaluation of Medicaid Demonstrations under New CMS Guidance: State Considerations and Financial Resource Requirements

The Centers for Medicare & Medicaid Services (CMS) has formalized and strengthened requirements for evaluation of state Section 1115 Medicaid demonstrations, including new demonstration programs being permitted by the current...more

Manatt, Phelps & Phillips, LLP

New Federal Guidance on Monitoring and Evaluation of Work Requirements and Other Coverage Demonstrations: What Does It Mean for...

Introduction - In March 2019, the Centers for Medicare & Medicaid Services (CMS) issued detailed guidance for states on the monitoring and evaluation of “eligibility and coverage” Section 1115 Medicaid demonstrations. The...more

Manatt, Phelps & Phillips, LLP

Arkansas’s Medicaid Work Requirement Challenged as Thousands Lose Coverage

During the first half of 2018, the Centers for Medicare & Medicaid Services (CMS) granted four states—Arkansas, Indiana, Kentucky and New Hampshire—Section 1115 waivers permitting them to condition Medicaid coverage for...more

Mintz - Health Care Viewpoints

ML Strategies – 2018 Health Care Preview

Happy New Year!?! 2017 was an eventful year for health care, and now we can all sit back and relax with very little concern that major health policy will be on the table in 2018. Right? Why must Speaker Ryan ruin our...more

King & Spalding

Appeals Court Upholds Charity Care Patient Population Exclusion from DSH Payments

King & Spalding on

On May 9, 2017, the U.S. Court of Appeals for the District of Columbia Circuit affirmed a lower court ruling denying hospitals from including New Jersey Charity Care Program (NJCCP) patients in the hospitals’ disproportionate...more

Baker Donelson

Medicaid: Significant Changes Coming in 2017 and Beyond

Baker Donelson on

With Congress back in session, attention in the health care policy universe is directed squarely at Washington, where Republicans in Congress and the Trump Administration are debating how to repeal and replace the Affordable...more

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