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 […]
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 January 5th under […]
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 reduce […]
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 […]
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 that take effect […]
HRSA issued a rule further delaying until October 1, 2017, the implementation of a January 5th final rule codifying the calculation of the 340B ceiling price, and implementing civil monetary penalties for manufacturers that knowingly and intentionally overcharge 340B providers. A […]
On April 28, CMS issued its proposed rule for Medicare’s inpatient prospective payment system (IPPS) for federal FY 2018. Among its provisions, CMS announced its proposal to phase in use of Medicare cost report data to determine the allocation of […]
On January 30, 2017, President Trump signed an Executive Order requiring agencies proposing any new regulation to identify at least two existing regulations for repeal. The Executive Order also directs agency heads that any new incremental costs associated with a […]
Just prior to the end of the Obama administration, on January 18, 2017, CMS published a final rule limiting the ability of states to create new or increased pass-through payments to providers in their Medicaid managed care programs. The rule’s […]
On January 20, 2017, the Trump administration issued a regulatory review memorandum, instructing agency heads to freeze new and pending regulations for review by the new administration. More specifically, the memorandum directs agency heads to: Send no regulations to the […]
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