Dec 30, 2018 | DSH, Litigation, News and Updates
As of December 30, 2018, CMS has withdrawn its policy on the inclusion of third party payments in calculating the disproportionate share hospital (DSH) limit. FAQs 33 & 34 require that states include commercial and Medicare payments, respectively, in their DSH...
Dec 27, 2018 | 340B, Litigation, News and Updates
On December 27, 2018, the United States District Court for the District of Columbia granted plaintiff hospitals’ motion to permanently enjoin HHS’ nearly 30% cut to certain 340B drugs. The Court held that in implementing its Medicare Part B rate reduction, the Agency...
Dec 10, 2018 | 340B, News and Updates, Rulemaking
On November 29, 2018, the Health Resources and Services Administration (HRSA) confirmed the effective date of its final rule on the 340B Drug Pricing Program. The rule institutes new ceiling prices on 340B drugs and authorizes monetary penalties against drug...
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...
