Tag Archives: DSH

Recently, my colleague Regina DeSantis told you about the ongoing saga involving disputes between 340B contract pharmacies and pharmaceutical manufacturers.  We often write about the 340B program on our blog because of the link between that program and the Medicaid prescription drug rebate program.

Well, we’re doing it again:  this time, because the U.S. Supreme Court just announced that it’s going to hear a dispute between some hospitals (340B covered entities) and CMS in the Court’s next term that starts in October. … More

We have long covered the handful of lawsuits that have been filed over the past several years concerning Medicaid disproportionate share hospital (“DSH”) payment policies.  These lawsuits all revolve around some steps that CMS had taken in recent years to exclude payments made for dual-eligible (Medicaid and Medicare) patients and payments made by private insurers from DSH hospitals’ uncompensated care costs.  CMS promulgated a rule to this effect,… More

On June 4, 2019, the House of Representatives’ Committee on Energy and Commerce, Subcommittee on Health, held a hearing entitled “Investing in America’s Health Care.”  Among other topics covered at the hearing was the future of the Medicaid disproportionate share hospital payment system, a topic that we have written about in the past.  Unless Congress acts, Medicaid DSH payments will be cut by $4 billion on October 1,… More

In 2006, former Massachusetts Governor Mitt Romney signed Chapter 58 of the Massachusetts Acts of 2006 into law.  Chapter 58 was designed to ensure that all Massachusetts residents would have access to some form of health insurance, and it accomplished this through reforms to the individual insurance market; subsidies to purchase health insurance; and an expansion of the Massachusetts Medicaid program, known as “MassHealth.”  Many observers have suggested that the enactment of Chapter 58 in Massachusetts paved the way for enactment of the Affordable Care Act at the federal level four years later (although Governor Romney strenuously denied this during his campaign for President in 2012).… More

We have posted over the past several months about some interesting Medicaid litigation across the country involving Medicaid disproportionate share (DSH) payments.  In this post, we try to explain a bit more about disproportionate share payments, how the payments work, and how the program has evolved over the past three and a half decades. As we discuss – this evolution has often been circuitous,… More

Last summer we wrote about an interesting court case involving payments to disproportionate share hospitals (DSH) under the Medicaid program.  It’s one of the hottest issues in Medicaid right now; seven courts have invalidated the CMS policy that is at issue.  The most recent decision came last week, in the US Court of Appeals for the First Circuit, involving a challenge brought by New Hampshire hospitals.… More

In the past several months, we have highlighted some fascinating Medicaid litigation against CMS in several US District Courts across the country.  This litigation deals with the Medicaid disproportionate share hospital (DSH) requirements of section 1923 of the Social Security Act.  But what we haven’t focused on – until now – is how the DSH program fits into the overall Medicaid financing system.  It’s a topic of enormous complexity with a rich 35-or more year history. … More