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Medicaid › Provider Payments › Hospitals

Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with... more +
Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with children.  less -
Smith Anderson

OBBB Act Brings Major Medicaid Changes: What North Carolina Providers Need to Know

Smith Anderson on

The One Big Beautiful Bill Act (P.L.119-21) (the “OBBB”) passed by slim margins in the U.S. Senate (51-50) and U.S. House (218-214) and was signed into law by President Trump on July 4, 2025....more

McDermott+

Overall Medicare Hospital Payments Will Increase in FY 2024, but Some Hospitals Could See a Decrease

McDermott+ on

Congress may be on summer break, but reg season is in full swing. Last week, the Centers for Medicare & Medicaid Services (CMS) released a final reg that will impact Medicare hospital payments in fiscal year (FY) 2024, which...more

ArentFox Schiff

Drastic Scheduled Cuts to Disproportionate Share Hospital Funding Would Increase Financial Distress for Safety Net Hospitals

ArentFox Schiff on

Over 2500 hospitals across the country historically have relied upon Disproportionate Share Hospital (DSH) Medicaid payments for financial stability. These DSH payments, made in large measure to hospitals with high Medicaid...more

Baker Donelson

A Flurry of Recent Activity Highlights Continued Interest in 340B Program Oversight

Baker Donelson on

Four separate government releases coming over a three-week period have once again highlighted the intense interest in the 340B drug pricing program, with a federal agency and two government watchdog groups issuing guidance...more

Baker Donelson

Administration Drug Pricing Proposals Could Reduce Provider Payments

Baker Donelson on

As the Trump Administration moves forward with proposed policy changes to address high drug prices, a common theme is emerging: a number of the proposals have the potential to reduce Medicare reimbursement to hospitals and...more

Baker Donelson

A SLIP on the LIP Adjustment: No Judicial Review Available for Hospitals' LIP Challenges

Baker Donelson on

In Northeast Hosp. Corp. v Sebelius, 657 F.3d 1 (D.C. Cir. 2011), the United States Court of Appeals for the District of Columbia Circuit upheld hospitals' challenge to CMS's disproportionate share hospital (DSH) calculation...more

Baker Donelson

OIG November 2017 Work Plan Update

Baker Donelson on

The OIG added four items to its Work Plan with the November 2017 update, as listed on the chart below. Interestingly, three of the four new items relate to Medicaid. Hot topics include prescriptions for extreme amounts of...more

Roetzel & Andress

Governor Kasich Releases $144 Billion State Budget Proposal - What You Need to Know

Roetzel & Andress on

Yesterday, Governor Kasich released the executive version of the state’s two-year operating budget (Fiscal Years 2018-2019), which includes proposed spending of over $144 billion during the biennium. Similar to his previous...more

Burr & Forman

2016 Health Care Year in Review

Burr & Forman on

Since I began writing this year-end review in 2013, there have been some common themes – a shift to pay for quality and away from fee-for service, much of which has been brought about by the Affordable Care Act (ACA): efforts...more

Baker Donelson

D.C. Circuit Precludes Review of DSH Uncompensated Care Data

Baker Donelson on

On July 26, 2016, the United States Court of Appeals for the District of Columbia Circuit decided Fla. Health Sciences Ctr. v. Burwell. In that case, the Court analyzed a statutory bar against judicial review of estimates...more

Morgan Lewis

Passage of the Bipartisan Budget Act: What You Should Not Do Now

Morgan Lewis on

Tips on preserving the provider-based status for existing clinics. The Bipartisan Budget Act of 2015 (H.R. 1314) was signed into law on Monday, November 2. Notwithstanding significant concerns raised by the hospital...more

Sheppard Mullin Richter & Hampton LLP

CMS Defines “Uninsured” for Medicaid DSH Payments But Leaves Impact on Hospital-Specific Payments Undefined

Sheppard Mullin Richter & Hampton LLP on

CMS’ Final Rule, “Medicaid; Disproportionate Share Hospital Payments – Uninsured Definition”, published on December 3, 2014, may offer relief to some hospitals receiving Medicaid disproportionate share hospital (DSH) payments...more

Akin Gump Strauss Hauer & Feld LLP

Software Glitch Sparks FCA Suit Against Hospitals for Late Repayment of Medicaid Reimbursements

Akin Gump Strauss Hauer & Feld LLP on

On June 27, the New York Attorney General’s Office and the U. S. Attorney’s Office for the Southern District of New York intervened in a qui tam suit against Continuum Health Partners, Inc., Beth Israel Medical Center and St....more

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