On November 9, 2020, CMS issued a managed care rule that largely finalizes policies proposed by the agency in a November 2018 proposed rule. Among other things, the final rule would eliminate prior approval requirements for directed payments implementing minimum fee schedules based […]
On September 14, 2020, CMS administrator Seema Verma issued a tweet announcing that the agency was withdrawing the Medicaid Fiscal Accountability Rule (MFAR) from the regulatory agenda. The rule was initially released in November 2019 and remains in proposed form.
On June 9, 2020, HHS announced an additional $15 billion distribution from the CARES Act Provider Relief Fund to Medicaid and CHIP providers. Specifically, the funds will be allocated to eligible providers who have not yet received a distribution from the General […]
On May 11, CMS released its Proposed Inpatient Prospective Payment Rule for FY 2021. The rule includes revisions to hospital payments and quality reporting requirements.
On April 20, The U.S. Court of Appeals for the Fifth Circuit became the third appeals to court to reinstate CMS’ 2017 final rule requiring states to include Medicare and commercial payments in their Medicaid DSH limit calculations. The rule […]
On April 10, 2020 CMS announced its delivery of the first $30 billion tranche of provider relief funding as part of the $100 billion CARES Act fund.
On April 6, 2020, a petition for writ of certiorari was filed in the DSH litigation case of Children’s Hospital Association of Texas v. Azar.
On January 30, 2020, CMS released a letter to state Medicaid directors outlining the agency’s block grant initiative titled “Healthy Adult Opportunity.” CMS will allow states to pursue either an aggregate cap or per-capita-cap approach to managing their Medicaid programs. The block […]
On January 27, 2020, the Governmental Accountability Office (GAO) released a report on the Medicaid 340B Drug Discount Program, particularly how the 340B program intersects with the Medicaid Drug Rebate Program. The GAO argued that a lack of transparency and documentation results […]
On January 8, 2020, the Centers for Medicare and Medicaid (CMS) issued an informational bulletin outlining a series of best practices for states to consider for avoiding duplicate discounts in the 340B program. According to CMS, the guidance is in […]