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New Hampshire Hospital Association v. Azar is Another Win for Hospitals in Medicaid DSH Reimbursement Litigation

On August 25, 2018, the U.S. District Court for the District of New Hampshire in New Hampshire Hospital Association v. Azar gavehospitals another victory in their claims that CMS unlawfully reduces Medicaid Disproportionate...more

GAO Report Finds CMS Needs to Better Target Risks to Improve Oversight of State-Reported Medicaid Expenditures

An August 2018 report by the Government Accountability Office (GAO) titled, “MEDICAID CMS Needs to Better Target Risks to Improve Oversight of Expenditures,” (the GAO Report) identified several weaknesses in CMS’s oversight...more

U.S. District Court Vacates Secretary’s Policy of Counting Exhausted Patient Days and Medicare Secondary Payor Days as Days...

On August 13, 2018, the United States District Court for the Eastern District of Washington decided Empire Health Foundation v. Price by vacating the Secretary’s policy of counting exhausted patient days and Medicare...more

D.C. District Court Sides with Secretary’s FY 2005 IPPS Final Rule Regarding DSH Calculation of Dual-Eligible Exhausted Days

On June 29, 2018, the U.S. District Court for the District of Columbia decided Stringfellow Memorial Hospital et al. v. Azar by granting summary judgment to the Secretary of HHS in his defense of the FY 2005 Inpatient...more

New Georgia Law Promotes Micro-Hospitals, Though CMS’s “Primarily Engaged” Standard Looms

On May 2, 2018, Georgia Governor Nathan Deal signed into law a bill allowing failed rural hospitals to be converted into “micro-hospitals.” The law comes as a response to a recent string of rural hospital closures and a...more

OIG Report Finds Many Outpatient Physical Therapy Services Did Not Comply With Medicare Requirements

Physical therapy providers are the target of a recent HHS Office of Inspector General (OIG) report that identified millions of dollars in overpayments for improperly billed Medicare services. The OIG selected a stratified...more

MedPAC Considers Recommendation to Cut Payment to Off-Campus Emergency Departments, Shift Payments to Rural Facilities

The Medicare Payment Advisory Commission (MedPAC) is considering asking Congress to cut Medicare payments for off-campus emergency departments located in urban areas and increase payments to stand-alone outpatient and...more

Trump Administration Proposes Expanding Short-term, Limited-duration Insurance Plans: A Potential Increase in Bad Debts for...

On February 20, 2018, the Trump administration announced a proposed rule to allow insurers to offer short-term, limited-duration insurance plans that provide coverage for a period of up to twelve months. The limit for this...more

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