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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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CMS Approves All-Payer ACOs and a New Take on Medicaid Delivery System Reform Investment in Vermont

Oct. 24, 2016: CMS has approved Vermont’s Medicaid 1115 demonstration program, an important component of the state’s all-payer Accountable Care Organization (ACO) model. The initiative, which also has received funding from the CMS Center for Medicare and Medicaid Innovation, seeks […]

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CMS Releases 2017 Medicaid Managed Care Rate Development Guide, but New Provider Payment Provisions Remain to be Addressed

Oct. 27, 2016: CMS has issued its Medicaid Managed Care Rate Development Guide for rating periods starting between January 1, 2017 and June 30, 2017.  A number of critical provisions from the new regulations, including provisions related to special contract […]

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