Nov 14, 2018 | DSH, Litigation, Medicaid, News and Updates
On November 14, 2018, in a 2-1 decision, the 6th Circuit affirmed a summary judgment ruling that CMS Medicaid DSH third party payer FAQs are procedurally invalid, while holding that CMS has the statutory authority to require the inclusion of Medicare and commercial...
Nov 13, 2018 | News and Updates, Waivers
On November 13, 2018, CMS notified state Medicaid directors of a new 1115 waiver opportunity for adults and children with serious mental health conditions. This new authority, similar to the agency’s substance use disorder waiver authority issued in November 2017,...
Nov 8, 2018 | Directed Payments, Medicaid Managed Care, Medicaid Managed Page, News and Updates, Rulemaking
On November 8, 2018, CMS released proposed regulations to amend the 2016 Medicaid Managed Care Rule. The proposed rule would allow states to establish new 3-year pass-through payments for populations transitioning into managed care, streamline the approval process for...
Nov 2, 2018 | Medicare, News and Updates, Rulemaking
On November 2, 2018, CMS issued its Hospital Outpatient and Prospective Payment System (OPPS) final rule. Of particular note, the agency finalized the proposal to extend the reduced payment rate provided under Section 603 of the Bipartisan Budget Act of 2015 (BBA) to...
Nov 1, 2018 | 340B, News and Updates, Rulemaking
Facing a legal challenge from the hospital industry, the Health Resources and Services Administration has proposed a January 1, 2019 effective date of a rule to establish a system to verify ceiling prices for 340B drugs, to provide web site access to the ceiling...
