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

by keith | Nov 1, 2017 | DSH, Medicaid, Medicare, News and Updates, Rulemaking

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...

HRSA Delays Rule on Determination of 340B Ceiling Prices and Manufacturer Penalties for Overcharging Providers

by keith | Nov 1, 2017 | 340B, News and Updates, Rulemaking

HRSA furthered delayed implementation of a final rule codifying the calculation of the 340B ceiling price, and implementing civil monetary penalties for manufacturers that knowingly and intentionally overcharge 340B providers.  The final rule had been published on...

CMS Proposes 27% Cut to Part B Payments for 340B Covered Drugs

by keith | Jul 20, 2017 | 340B, News and Updates

In its proposed rule implementing changes to the Medicare Outpatient Prospective Payment System, CMS has proposed to reduce payments to hospitals for separately payable drugs that are eligible for discounts under the 340B Drug Pricing Program.  Specifically, CMS would...

CMS Posts Changes to Waiver Budget Neutrality Policy

by keith | Jul 11, 2017 | Medicaid, News and Updates, Waivers

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...

CMS Announces “Targeted” Discretion in Enforcing Medicaid Managed Care Rule Deadlines

by keith | Jun 30, 2017 | News and Updates

On June 30, CMS issued an Informational Bulletin announcing that it will use “targeted” enforcement discretion to work with states that are unable to meet the Medicaid managed care rule’s original deadlines for compliance, particularly those rules...
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