Medicaid DSH Third-Party Payer Policy for Periods Prior to 2017 Withdrawn by CMS; Final Rule Adopted in 2017 Still Under Dispute and Awaiting Appellate Court Decisions

* As of December 30, 2018, CMS will no longer be enforcing FAQs 33 & 34 and has withdrawn them from its 2010 Medicaid DSH guidance.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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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 other innovations.  Eyman Associates will […]

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