Tag Archives: financing

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

We’ve posted previously the long-standing rumor (substantiated by several folks within the Administration) that CMS is working on a guidance document to states to receive their Medicaid funding through a block grant. In June, the Office of Management and Budget (OMB) received a guidance document entitled, “State Medicaid Director Letter: Medicaid Value and Accountability Demonstration Opportunity.” This document was widely reported by press as the block grant guidance document.  … More

Earlier this week, CMS released for publication a proposed rule that would add some degree of transparency and oversight to the somewhat opaque world of Medicaid financing.  It’s a topic that’s fascinated us here at the Medicaid and the Law Blog for some time and we’ve written about it on a couple of occasions.  Over the years, Congress and CMS (and even before there was a CMS,… 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

Here is a video from my recent guest lecture at George Mason University about Medicare and U.S. Healthcare Spending.

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