Payer Roundup—CMS approves Medicaid work requirements in New Hampshire; D.C. court weighs 340B case

CMS approves New Hampshire's work requirements waiver 

The Centers for Medicare & Medicaid Services (CMS) has approved its fourth state waiver for Medicaid work requirements. 

The agency granted New Hampshire's waiver which requires Medicaid beneficiaries to participate in 100 hours per month of "community engagement activities" including employment, education, job skills training, or community service. 

"Work requirements help lift able-bodied individuals out of poverty by empowering them with the dignity of work and self-reliability while also allowing states to control the costs of their Medicaid programs," Gov. Chris Sununu said in a statement. "They help people gain the skills necessary for long-term independence and success."

CMS already approved work requirements in Arkansas, Indiana and Kentucky. Following New Hampshire's approval, there are six other states with pending applications. (Approval Letter

D.C. appeals court hears arguments on 340B payments  

The U.S. Court of Appeals for the District of Columbia is set to weigh in on a case brought by several hospital associations seeking an injunction on the 30% cut to Medicare payments for 340B drugs.  

The appeals court heard oral arguments on Friday following a brief (PDF) filed by the American Hospital Association, the Association of American Medical Colleges, America's Essential Hospitals and three hospital organizations pushing for a preliminary injunction to the payment reduction. A ruling is expected sometime this summer. (AHA News).  

Former CMS employee convicted of fraud and insider trading 

A former CMS employee was convicted participating in an insider trading scheme along with a political consultant and two healthcare hedge fund managers. 

Christopher Worrall, who began working at CMS in 1999, fed confidential agency information regarding reimbursement decisions to a political intelligence consultant who passed the information to analysts at Deerfield Management Company which reaped more than $7 million in profits. (Release

Idaho officials plead case to sell plans outside of ACA rules 

Idaho officials are seeking approval from CMS to sell insurance plans on the individual market that don't meet ACA requirements around risk pools, risk adjustment and essential health benefits. 

Idaho Department of Insurance Director Dean Cameron says the leeway is necessary given the state's rising premiums and uninsured rate. But federal regulators say they are obliged to adhere to the law. (Associated Press