news and updates
HHS Rolls Back Policy Requiring Public Notice and Comment for Certain Types of Rulemaking
On March 3, 2025, the Department of Health and Human Services (HHS) announced the rescission of a long-standing agency policy colloquially known as the “Richardson Waiver,” which could dramatically curtail public notice and opportunity to comment on regulatory changes...
CMS Rescinds Guidance on Supporting Health-Related Social Needs in Medicaid & CHIP
The Centers for Medicare & Medicaid Services (CMS) recently rescinded Biden era guidance related to the coverage of health-related social needs (HRSN) services and supports in Medicaid and the Children’s Health Insurance Programs (CHIP). CMS has defined HRSNs as...
CMS Clarifies Types of New Provider Tax Hold Harmless Arrangements Ineligible for Enforcement Discretion Under April 2024 Bulletin
In a presentation to state Medicaid directors, CMS recently clarified how it plans to exercise its enforcement discretion under its April 22, 2024 (CIB). In that CIB, CMS announced it will not enforce its policy prohibiting provider assessment programs involving...
CMS Releases Final Managed Care Rule, Final Access Rule, and Informational Bulletin on Provider Tax Hold Harmless Arrangements
The Centers for Medicare & Medicaid Services (CMS) has released its long-anticipated final Medicaid managed care rule, codifying a policy that allows hospitals to receive reimbursement equivalent to commercial rates in Medicaid managed care to promote access to...
CMS Proposes Modest Payment Increases in Medicare Inpatient Prospective Payment System (IPPS) Rule for FY 2025
The Centers for Medicare & Medicaid Services (CMS) has released its proposed IPPS rule for FY 2025, which proposes modest increases in the annual payment update (a 2.6% increase) and Medicare disproportionate share hospital (DSH) payments (estimated to be $9.98...
HRSA Finalizes Revamped 340B Alternative Dispute Resolution (ADR) Rules
The Health Resources and Services Administration (HRSA) finalized its changes to the 2020 ADR rule intended to improve accessibility and limit administrative burden. Among its provisions: the ADR panels will comprise only Office of Pharmacy Affairs staff as opposed to...
Arkansas 340B Contract Pharmacy Law Upheld by 8th Circuit
On March 12, 2024, a three judge panel of the 8th Circuit federal court of appeals confirmed that Arkansas’s law protecting 340B contract pharmacies in the state against discriminatory practices by manufacturers is not preempted by federal law. (AstraZeneca...
Eyman Partners Adds New Senior Attorney, Sandra George
Eyman Partners is pleased to announce that attorney Sandra George has joined the firm as a Senior Advisor. Sandra joins us after nearly two decades of federal health care oversight experience. This follows several years of private practice alongside Barbara Eyman,...
CMS Releases Final Rule on Treatment of Dual Eligible Costs in Hospital DSH Limits
On February 23, 2024, CMS released a final rule implementing the new policy on counting third-party payer costs and revenues in the hospital-specific disproportionate share hospital (DSH) cap, as mandated by Congress in the Consolidated Appropriations Act of 2021. The...
CMS Approves New York Health Equity Reform Waiver Amendment that Includes Significant Investments for Safety-Net Hospitals
In January, CMS approved an amendment to New York’s section 1115 demonstration that will provide significant investments in advancing health equity and supporting the delivery of health-related social need (HRSN) services. A central component of the approved...
Federal Court Overturns Restrictive Interpretation of 340B Patient Definition, Confirms HRSA Authority to Define Patient
A federal court in South Carolina issued the first federal court decision related to the definition of a patient to whom a covered entity may provide 340B-discounted drugs. In Genesis Health Care, Inc. v. Becerra, the court concluded that HRSA’s enforcement action...
CMS Proposes to Repay 340B Hospitals $9 Billion in One-Time Lump Sum Payments to Remedy Unlawful OPPS Cuts
CMS has proposed a long-awaited remedy to make 340B hospitals whole for nearly five years of cuts under the Medicare outpatient prospective payment system (OPPS) that the Supreme Court deemed unlawful in 2022. In welcome news, CMS has proposed to repay impacted...
Texas District Court Issues Preliminary Injunction Prohibiting CMS From Applying Provider Tax Mitigation Policy in Texas
A Texas district court judge has issued a preliminary ruling in Texas’ lawsuit challenging an Informational Bulletin released by CMS’ Centers for Medicaid and CHIP Services (CMCS) in February 2023 purporting to prohibit certain voluntary redistribution agreements...
Eyman Partners Announces Elevation of Sarah Mutinsky and Eva Johnson to Principal
With great pleasure, Eyman Partners announces the elevation of its long-time senior attorneys, Sarah Mutinsky and Eva Johnson, to Principal, alongside founding Principal, Barbara Eyman. Over the last decade, Sarah and Eva have helped to build the firm’s unique and...
CMS Proposes Changes to Medicaid Managed Care Rules, Including on State Directed Payments
On Thursday, April 27, the Centers for Medicare & Medicaid Services (CMS) issued a long-anticipated proposed rule related to Medicaid and CHIP managed care programs. Of particular importance for many of our clients across the country, CMS continued its practice of...
CMCS Releases Informational Bulletin Clarifying Hold-Harmless Policy
CMS’ Centers for Medicaid and CHIP Services (CMCS) has released an Informational Bulletin stating its interpretation of federal laws related to Medicaid payments where the state share is derived from a provider tax. The bulletin specifically addresses private...
CMS Issues Proposed Rule Implementing Disproportionate Share Hospital Third-Party Payer Law
The Centers for Medicare & Medicaid Services (CMS) has released its proposed rule implementing Section 203 of the Consolidated Appropriations Act of 2021, which altered the calculation of the Medicaid hospital-specific DSH limit to exclude costs and payments...
Third Circuit Issues Unfavorable Decision Allowing Drug Manufacturers to Continue Restrictive Contract Pharmacy Policies
The first of three federal circuits to consider the authority of the Health Resources and Services Administration (HRSA) to prohibit drug manufacturer contract pharmacy restrictions issued an unfavorable decision for hospitals, ruling that the federal 340B statute is...