The Centers for Medicare & Medicaid Services is appealing a federal court decision that barred the agency from enforcing in Missouri a 2017 final rule and earlier guidance that included private insurance and Medicare payments when calculating the Medicaid shortfall component of the hospital-specific limit on disproportionate share hospital payments. The case was brought by the Missouri Hospital Association. A federal court in the District of Columbia later voided the rule, meaning it no longer applies nationally. The deadline for the government to file an appeal in the D.C. case is May 7.