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Medicaid DSH Third-Party Payer Policy for Periods Prior to 2017 Withdrawn by CMS; Final Rule Adopted in 2017 Still Under Dispute and Awaiting Appellate Court Decisions

* As of December 30, 2018, CMS will no longer be enforcing FAQs 33 & 34 and has withdrawn them from its 2010 Medicaid DSH guidance. Over the last several years, courts in various jurisdictions have issued rulings in lawsuits challenging […]

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CMS Finalizes Medicaid DSH Regulations Regarding Treatment of Medicare and Commercial Payments for the Dual Eligibles

The Centers for Medicare & Medicaid Services (CMS) finalized regulations requiring states to include Medicare or commercial payments for services provided to dually eligible Medicaid patients when calculating the hospital-specific limit on DSH payments during annual DSH audits. For some […]

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