news and updates
Lawmakers Sign Bipartisan Letter to delay DSH Cuts
Over 220 Republican and Democratic lawmakers signed a letter to House leaders urging them to delay cuts to Medicaid disproportionate share hospital payments.
GOP Senators Release New ACA Repeal Bill Prior to Reconciliation Lapse
In a final effort prior to the expiration of their budget reconciliation bill on September 30th, Republican senators Lindsey Graham (SC) and Bill Cassidy (LA) have introduced a new proposal to repeal the Affordable Care Act. The plan would terminate the ACA's Medicaid...
CMS Proposes 27% Cut to Part B Payments for 340B Covered Drugs
In its proposed rule implementing changes to the Medicare Outpatient Prospective Payment System, CMS has proposed to reduce payments to hospitals for separately payable drugs that are eligible for discounts under the 340B Drug Pricing Program. Specifically, CMS would...
Eyman Partners Releases Analysis of Ongoing Medicaid DSH Litigation
Click here for the analysis.
CMS Posts Changes to Waiver Budget Neutrality Policy
CMS has posted on its website a presentation from May 2016 announcing significant changes to its budget neutrality policy for Section 1115 demonstrations. The policy could restrict states' abilities to continue or newly implement Medicaid provider payment programs or...
CMS Announces “Targeted” Discretion in Enforcing Medicaid Managed Care Rule Deadlines
On June 30, CMS issued an Informational Bulletin announcing that it will use "targeted" enforcement discretion to work with states that are unable to meet the Medicaid managed care rule's original deadlines for compliance, particularly those rules that take effect for...
Senate Adds Continuous Coverage Provision to “Better Care Reconciliation Act”
On June 26th, the Senate released a new version of its health reform repeal and replace bill, the Better Care Reconciliation Act, that would impose a six month waiting period to begin coverage for people with significant breaks in coverage during a year. The initial...
Congressional Budget Office Releases Score of Senate “Better Care Reconciliation Act”
On June 26, the CBO released its score of the Senate's version of the repeal and replace act, the "Better Care Reconciliation Act." According to the CBO, the Senate bill would save roughly $321 billion over 10 years--$202 billion more than the House’s American Health...
Senate Releases Discussion Draft of Health Reform Bill
On June 22, 2017, the Senate released a discussion draft of its version of the House's "American Health Care Act." The Senate's "Better Care Reconciliation Act of 2017" includes many of the provisions of the House bill, including significant cuts to the Medicaid...
CMS Issues Tool for 1332 Waivers in Effort to Stabilize 2018 Insurance Markets
On May 16, CMS released a 1332 Innovation Waiver Checklist intended to assist states in seeking waivers of Affordable Care Act requirements to allow for the establishment of high-risk pools and state operated reinsurance programs. CMS hopes the new tool will help...
HRSA Opts to Delay 340B Ceiling Price and Manufacturer Overcharging Penalty Rules until October 1, 2017
HRSA issued a rule further delaying until October 1, 2017, the implementation of a January 5th final rule codifying the calculation of the 340B ceiling price, and implementing civil monetary penalties for manufacturers that knowingly and intentionally overcharge 340B...
House Passes American Health Care Act (AHCA)
On May 4, 2017, the U.S. House of Representative passed the American Health Care Act (AHCA, H.R. 1628) by a vote of 217-213. The text of the bill as well as the amendments that were ultimately adopted in order to secure passage are available here. These amendments...
CMS Issues Proposed Rule for FY2018 Medicare Inpatient Hospital Payments
On April 28, CMS issued its proposed rule for Medicare’s inpatient prospective payment system (IPPS) for federal FY 2018. Among its provisions, CMS announced its proposal to phase in use of Medicare cost report data to determine the allocation of the uncompensated...
NH Court Sides with Hospitals in DSH Cap Litigation
On March 2, 2017, United States District Court for the District of New Hampshire issued its order granting summary judgement for the New Hampshire Hospital Association (NHHA) in the case of New Hampshire Hospital Association v. Burwell. The ruling represents a...
Leaked Draft of House Republican Repeal Bill
On February 24th 2017, a leaked draft of the House Republican bill to repeal the ACA was obtained by multiple news publications. The bill would institute per capita caps into the Medicaid program and roll back the program's overall spending. It would set aside funds...
President Trump Issues Executive Order Seeking to Reduce Regulatory Burden
On January 30, 2017, President Trump signed an Executive Order requiring agencies proposing any new regulation to identify at least two existing regulations for repeal. The Executive Order also directs agency heads that any new incremental costs associated with a new...
CMS Issues Final Rule Limiting New Pass-Through Payments
Just prior to the end of the Obama administration, on January 18, 2017, CMS published a final rule limiting the ability of states to create new or increased pass-through payments to providers in their Medicaid managed care programs. The rule’s effective date was...
Trump Administration Issues Regulatory Freeze
On January 20, 2017, the Trump administration issued a regulatory review memorandum, instructing agency heads to freeze new and pending regulations for review by the new administration. More specifically, the memorandum directs agency heads to: Send no regulations to...