Articles and Blogs

In Becerra v. Empire Health Found., the Supreme Court upheld CMS’s decision to include Medicare exhaust and secondary payor days in the Medicare Fraction of the Disproportionate Share Hospital (“DSH”) statute. Although a loss for the hospitals in Empire, the ruling may support hospitals seeking to add SSI days to the numerator of the... READ MORE

House and Senate Panels Announce Surprise Billing Fix On December 8, leaders from the Senate Health, Education, Labor, and Pensions (“HELP”) and House Energy and Commerce committees announced an agreement on surprise billing legislation. The proposal is intended to end surprise billing of patients by creating a new system of dispute resolution that includes... READ MORE

Passage of Temporary Funding Bill Ends Potential Shutdown Just hours before the previous short-term agreement was set to expire on November 21, President Trump signed a bill funding the government through December 20. This measure gives Congress four additional weeks to reach a consensus on how to fund the government in FY 2020. The... READ MORE

Another Band-Aid: Congress Clears Continuing Resolution to Avoid Shutdown On Thursday, the Senate cleared legislation (H.R. 4378) by a vote of 82-15 to fund federal agencies and extend several health care-related programs through November 21. The vote on the continuing resolution followed House approval of the measure, which overwhelmingly passed the measure last week.... READ MORE

A federal district court in Connecticut recently applied the Supreme Court’s favorable opinion in the Allina case (which we previously wrote about here), compelling the Secretary to adhere to notice-and-comment rulemaking of Medicare policy when it affects providers’ eligibility, benefits or payment. Additionally, CMS cannot use a preclusion statute to avoid challenges for which it did not... READ MORE

Recently, the D.C. District Court ruled that HHS must include certain waiver programs in its Medicare disproportionate share calculations. This is a significant ruling because many states have experimented with different ways to provide health care to low-income populations. As a result, hospitals serving these populations may be entitled to increased payments.[1] Background Under... READ MORE

House Subcommittee Passes Surprise Billing Measure Despite Member Disagreement On Thursday, the Energy and Commerce Health Subcommittee approved 10 bills, including a measure addressing surprise medical billing. The “No Surprises Act” (H.R. 3630), introduced by Energy and Commerce Chairman Frank Pallone (D-NJ) and Ranking Member Greg Walden (R-OR), would prohibit surprise billing and limit... READ MORE