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The U.S. Court of Appeals for the 8th Circuit this week a district court ruling that permanently barred the Centers for Medicare & Medicaid Services from including private insurance and Medicare payments when calculating the Medicaid shortfall component of the hospital-specific limit on disproportionate share hospital payments. In August, the Court of Appeals for the District of Columbia Circuit also reversed a district court decision that voided the 2017 rule. A request by the hospitals for a rehearing is pending, as are appeals in other court cases involving the rule.