On October 9, 2019, the Trump administration released two proposed rules seeking to revamp current fraud and abuse regulations to support the transition to value-based payment. The first would amend regulations implementing the anti-kickback statute and civil monetary penalty law […]
On September 26, 2019, the Senate approved a bipartisan continuing resolution to temporarily delay $4 billion in cuts to Medicaid disproportionate share hospital (DSH) payments. The cuts, originally set to take place on October 1, will now take effect on […]
On September 23, 2019, CMS issued a final rule implementing its Disproportionate Share Hospital (DSH) reduction methodology. The DSH payment cuts were part of the Affordable Care Act (ACA) and are currently scheduled to begin in 2020 after a series […]
On September 18, 2019, the D.C. District Court ruled that CMS exceeded its authority when it extended site-neutral payment to certain services in grandfathered clinics. The policy, issued as part of the November 2018 Outpatient Prospective Payment System (OPPS) Final […]
Over the last several years, courts in various jurisdictions have issued rulings in lawsuits challenging the Centers for Medicare & Medicaid Services’ (CMS’) policy requiring the inclusion of Medicare and commercial payments in the calculation of the Medicaid disproportionate share […]
On August 16, 2019, CMS issued its FY 2019 Inpatient Prospective Payment Systems (IPPS) Final Rule.
On August 14, 2019, the Department of Homeland Security (DHS) issued a final rule expanding the types of public benefits that may be considered when assessing whether an individual is a “public charge” for purposes of altering their immigration status. The rule allows […]
On August 13, 2019, the D.C. Circuit issued its highly-anticipated decision in a lawsuit brought by the Children’s Hospital Association of Texas (CHAT) and others, challenging the legality of CMS’ 2017 Medicaid DSH third-party payer final rule that was set […]
On August 9, 2019, CMS issued its FY 2019 Outpatient Prospective Payment Systems (OPPS) Proposed Rule.
On June 24, 2019, President Trump issued an executive order on price and quality transparency, requiring the Department of Health and Human Services and the Secretary of the Treasure to issue a variety of proposed regulations and guidance within 60 […]