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 […]

On December 2, 2019, the Texas Health and Human Services Commission filed suit against HHS seeking reversal of an August 2018 DAB decision that upheld a $25 million disallowance against the state. The complaint, filed in D.C District Court, argues […]

On Friday November 15, the Trump administration released a set of rules aimed at increasing transparency in the hospital and health insurance industries. A proposed rule targeting both exchange and employer-sponsored health plans would require insurers to disclose their negotiated […]