skip to main content


CMS Issues Final Rule on Denial of Medicaid Payments for "Hospital Acquired Conditions"

June 3, 2011

Authors: Joan W. Feldman, Vincenzo Carannante, William J. Roberts

On June 1, 2011, pursuant to Section 2702 of the Patient Protection and Affordable Care Act, CMS issued a final rule (the “Rule”) that prohibits states from making Medicaid payments to health care providers for items and services included on Medicare’s list of “Hospital Acquired Conditions.”  The Medicare list of Hospital Acquired Conditions will be the baseline list of services for which payment will be denied as the Rule permits states to identify additional preventable conditions for which Medicaid payment will be denied.  The Rule becomes effective July 1, 2011, but CMS has stated that “it intends to delay compliance action on these provisions until July 1, 2012” to allow states to make the appropriate changes to their State Plans and give providers time to adjust and prepare.

If you have any questions about this Rule, please contact any of the members of Shipman & Goodwin's Health Law Practice Group.

© Shipman & Goodwin LLP, 2019. All Rights Reserved.