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Medicare Trustees Release 2018 Annual Report

On June 5, 2018, the Medicare Boards of Trustees (the Board) released its annual report on the fiscal condition of the Medicare trust funds: the Hospital Insurance (HI) trust fund, which supports Medicare Part A, and the...more

First Circuit Rejects CMS FAQs Clarifying Medicaid DSH Payment Calculations

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

Judge Denies HHS’s Request to Rescind Timeline to Eliminate the Medicare Appeals Backlog

On January 4, 2017, the court in the American Hospital Association (AHA) v. Burwell litigation denied HHS’s motion to reconsider, which means that HHS must comply with the court’s timeline to eliminate the Medicare appeals...more

HHS Says Claims Appeals Backlog Is Decreasing and May Be Eliminated by the End of FY 2019

On November 7, 2016, in the pending American Hospital Association (AHA) v. Burwell litigation, HHS filed a motion for summary judgment. A central focus of HHS’s motion for summary judgment is assertions that “the backlog is...more

60-Day Overpayment FCA Enforcement Action Results in $2.95 Million Settlement

On August 23, 2016, a New York hospital system settled False Claims Act (FCA) allegations that it violated the 60-day overpayment rule by improperly retaining Medicaid overpayments. The whistleblower alleged that three of the...more

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