News & Analysis as of

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

2014 Physician Fee Schedule: Cuts and Quality and Data! Oh My!

The Centers for Medicare and Medicaid Services (CMS) recently released the calendar year 2014 Physician Fee Schedule Proposed Rule (Proposed Rule)....more

DC Circuit Issues Latest DSH Decision, Reducing Reimbursements

On June 11, 2013, the D.C. Circuit Court issued the latest ruling relating to the proper calculation of hospitals’ disproportionate share hospital (DSH) payment, leading to potentially lower Medicare reimbursements related to...more

Under The Dome: Inside The Maine State House 6-14-13

In This Issue: Governor LePage Issues an Additional Veto; Congressman Michaud Explores a Run for Governor; Biennial Budget Proceeds Through the Legislature; Legislation to Repay Maine Hospitals Sent to Governor LePage;...more

Hospitals: Audits And Compliance

Hospitals are under intense scrutiny. The federal government knows that one sure way to reduce healthcare costs is to get hospitals to lower their costs. Hospitals feel the pinch given the need to generate revenue but know...more

Court Places Limits on Secretary's "No Reopening" Arguments

CMS has often argued that “base year” determinations cannot be revisited once the three-year reopening period has closed. Now, a recent decision from the U.S. Court of Appeals for the District of Columbia Circuit places those...more

MedPAC Issues FY 2014 Payment Recommendations for Inpatient and Outpatient Hospitals, LTCHs, Hospices and ASCs

The Medicare Payment Advisory Commission (MedPAC), an independent Congressional agency established to advise Congress on issues affecting the Medicare program, recently voted on FY 2014 payment recommendations for: (1)...more

Supreme Court Opinion in Sebelius v. Auburn Regional Medical Center Rejects a Challenge by Hospitals to Medicare's SSI Fraction...

A unanimous Supreme Court has issued its opinion in Sebelius v. Auburn Regional Medical Center, No. 11-1231 (Jan. 22, 2013), rejecting a challenge by hospitals to Medicare's Supplemental Security Income ("SSI") fraction...more

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