Resources

Coronavirus Resources

This page collects some of the COVID-19-related federal laws, regulations and guidance that is most relevant to Eyman Associates’ clients and friends. Please feel free to reach out to any of our team members to help you navigate these complex policies during this...

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340B Drug Discount Program

HRSA Office of Pharmacy Affairs Program Website Law and Guidance Section 340B of the Public Health Service Act Selected Critical Guidance NEW: Proposed OPPS Rule, 340B Excerpt (July 20, 2017) NEW: OPA Withdrawal of Omnibus Guidance (Jan. 2017) 340B Drug Pricing...

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DSRIPs and Related Programs

At Eyman Associates, we monitor developments in the use of 1115 waiver demonstrations to support delivery system transformation on an ongoing basis and strive to provide the most current and thorough information possible for our clients. Current Program: Public...

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Uncompensated Care Pools

A number of state Medicaid programs have received approval under 1115 demonstration authority for funding pools to compensate providers for the uncompensated costs of serving Medicaid and uninsured individuals, in particular to ensure sufficient support for certain...

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Medicaid Managed Care

Key Resources on Medicaid Managed Care CMS Published Rules and Regulations Proposed Rule on New Pass-Through Payments CMS 2016 Final Medicaid Managed Care Rule CMS 2015 Proposed Medicaid Managed Care Rule CMS 2002 Final Medicaid Managed Care Rule CMS 2001 Proposed...

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CMS Issues Proposed IPPS Rule

The Centers for Medicare & Medicaid Services (CMS) has released its proposed inpatient prospective payment system (IPPS) rule for fiscal year 2023, with changes that would impact reporting used to calculate Medicare disproportionate share hospital (DSH) payments,...

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FMAP-Enhanced DSH Allotments Announced

CMS published a Federal Register Notice on March 16, 2022 implementing a congressionally-mandated increase in Medicaid Disproportionate Share Hospital (DSH) allotments for FYs 2020 and 2021 to account for the enhanced federal Medicaid matching rates during the public...

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Senate Approves Temporary Delay in DSH Cuts

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 November 22nd.

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CMS Issues Final Rule on DSH Cut Methodology

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 of two-year delays....

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DHS Issues Final Rule on Public Charge

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...

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D.C. Circuit Reverses Lower Court’s Ruling in DSH Litigation

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 to take...

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MACPAC Releases Recommendations on Medicaid DSH Cuts

On March 18, 2019, MACPAC published its recommendations for restructuring the Medicaid disproportionate share hospital (DSH) program. In its March 2019 Report to Congress, MACPAC outlined three recommendations for minimizing the impact of DSH cuts on safety net...

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CMS Withdraws FAQs 33 & 34 Amidst Ongoing DSH Litigation

As of December 30, 2018, CMS has withdrawn its policy on the inclusion of third party payments in calculating the disproportionate share hospital (DSH) limit. FAQs 33 & 34 require that states include commercial and Medicare payments, respectively, in their DSH...

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Supreme Court Agrees to Hear $4B Medicare DSH Case

On September 27, 2018, the Supreme Court granted certiorari in Azar v. Allina Health Services, et al. The Court will hear arguments on whether HHS was required to go through notice and comment before implementing a rule that altered the Medicare reimbursement formula...

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CMS Files Appeal to 8th Circuit on Final Rule in DSH Lawsuit

On April 10, 2018, CMS filed a notice of appeal to the 8th Circuit in the litigation of Missouri Hospital Association v. Price. This will be the first appellate court to hear arguments on the April 2017 Final Rule. It follows a First Circuit ruling earlier this month...

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