by keith | Jun 28, 2022 | Medicaid Managed Care
Both The Medicaid and CHIP Access and Payment Commission and the Government Accountability Office have recently published recommendations for increasing transparency of managed care directed payment programs to facilitate closer evaluation of direct payment programs....
by keith | Jun 16, 2022 | 340B
The Supreme Court issued a unanimous opinion in American Hospital Association v. Becerra on June 15, 2022, concluding in a “straightforward” decision that the Medicare reimbursement cuts for certain separately-payable outpatient drugs implemented in the...
by keith | Apr 18, 2022 | DSH, Medicare, News and Updates
The Centers for Medicare & Medicaid Services (CMS) has released its proposed inpatient prospective payment system (IPPS) rule for fiscal year 2023, with changes that would impact reporting used to calculate Medicare disproportionate share hospital (DSH) payments,...
by keith | Mar 16, 2022 | DSH, Medicaid, News and Updates
CMS published a Federal Register Notice on March 16, 2022 implementing a congressionally-mandated increase in Medicaid Disproportionate Share Hospital (DSH) allotments for FYs 2020 and 2021 to account for the enhanced federal Medicaid matching rates during the public...
by keith | Mar 14, 2022 | DSH, Medicaid, News and Updates, Resources
The rules governing how to treat costs and revenues for hospital services provided to dually-eligible Medicaid patients for purposes of calculating the limit on Medicaid disproportionate share hospital (DSH) payments to a particular hospital have been repeatedly...
by keith | Dec 31, 2021 | Medicaid, Medicaid Managed Care, News and Updates, Waivers
In December, CMS approved some of California’s CalAim proposals through extensions of its 1115 demonstration and 1915(b) managed care waivers. California is transitioning significant programs under its prior 1115 waiver into its 1915(b) waiver, and working to sustain...
