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Health Law Monitor

Medicare and Medicaid issues

SCOTUS Says a Medicare Patient is Included in the DSH Medicare Fraction Even if Medicare Does Not Pay

Earlier this summer, the Supreme Court issued an opinion in Becerra v. Empire Health Foundation, a case where a hospital challenged the Department of Health and Human Services (“HHS”) interpretation of a 2004 regulation affecting the way Medicare’s disproportionate share hospital (“DSH”) adjustments are calculated. The Supreme Court upheld HHS’s interpretation, much to the disappointment of the…

HHS Sets Clear Goals and Timeline to Transition From Volume to Value-Based Medicare Reimbursement

On January 26, 2015, the United States Department of Health and Human Services (“HHS”) Secretary Sylvia M. Burwell (the “Secretary”) reiterated the government’s commitment to move Medicare from fee-for-service (FFS) payments to value-based reimbursement.  The Secretary published measurable goals and a timeline for the Medicare program to pay providers based on quality rather than…


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