News and Updates

CMS Approves 10-year Renewal of Texas 1115 Waiver

On January 15, 2021, CMS approved a 10-year renewal of Texas’ Section 1115 Medicaid waiver using emergency authority to bypass notice and comment requirements. The renewed waiver will extend and expand the state’s Uncompensated Care Pool and envisions the adoption of...

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CMS approves new 10-year TennCare III waiver

On January 8, 2021, CMS approved a new 10-year TennCare III waiver establishing a fixed aggregate dollar cap on funding accompanied by increased flexibility to make program changes and an opportunity for shared savings.

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CMS Releases New Guidance on Managed Care Directed Payments

On January 8, 2021, the Centers for Medicare & Medicaid Services (CMS) issued a State Medicaid Director Letter (SMDL) outlining additional guidance on Medicaid managed care directed payments, as well as a revised preprint form for use in seeking approval of...

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CMS Approves 1-Year Extension of CA 1115 Waiver Demonstration

On December 29, 2020, the Centers for Medicare & Medicaid Services (CMS) approved California’s request to extend its 1115 waiver demonstration, “Medi-Cal 2020,” for one year. Medi-Cal 2020 was approved for a five-year period on December 30, 2015, building off...

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HRSA Publishes Alternative Dispute Resolution Final Rule

On December 14, 2020, the Health and Resource Service Administration (HRSA) published a Final Rule specifying the requirements and procedures for the 340B Program's administrative dispute resolution (ADR) process. The process was established to support covered...

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CMS Issues Medicaid Managed Care Final Rule

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...

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CMS Announces Withdrawal of MFAR

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.

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