Tag Archives: DSRIP

For our discussion of the new “closed formulary” flexibility approved in Tennessee, you can read our follow-up post here. 

Introduction

On Friday January 8th, in the final days of the Trump Administration, CMS announced approval of a first-in-the-nation waiver that would permit Tennessee to transition from Medicaid’s longstanding, open-ended financing model to a modified “block grant” model – a financing system under which the Federal government has agreed to commit a discrete amount of dollars to the state,… 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

On December 15, 2017, CMS Director Brian Neale informed State Medicaid Directors of CMS’ intent to phase out funding for Designated State Health Programs (DSHP) in Section 1115 waivers.  CMS will no longer approve waiver requests under Section 1115 for DSHP funding, and will not renew portions of existing waivers that provide DSHP funding.

DSHP funding in Section 1115 waivers developed alongside of CMS’ funding of Delivery System Reform Incentive Payments (“DSRIP”) following the passage of the Affordable Care Act in 2010. … More