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CMS Clarifies Medicaid DSH Rule

Last week the Centers for Medicare & Medicaid Services announced a final rule addressing the treatment of third-party payers in calculating Medicaid uncompensated care costs.  This calculation affects individual hospitals’ Medicaid disproportionate share (Medicaid DSH) limit. According to CMS, This rule clarifies federal requirements regarding the treatment of third party payers in determining the hospital-specific Medicaid DSH payment limit, which is set by statute as a hospital’s “uncompensated costs” incurred in providing hospital services to Medicaid and uninsured patients. The final rule makes clearer our existing policy that uncompensated costs include only those costs for Medicaid eligible individuals that remain [&hellip

MACPAC Looks at Medicaid DSH

Hospitals that serve especially large numbers of Medicaid and low-income patients still need Medicaid disproportionate share hospital payments (Medicaid DSH) to avoid red ink despite the expansion of Medicaid and the increase in the number of uninsured people fostered by the Affordable Care Act. So concludes the Medicaid and CHIP Payment and Access Commission (MACPAC) the non-partisan legislative branch agency that advises Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on Medicaid and Children’s Health Insurance Program issues. In its March 2017 report to Congress, MACPAC writes that In both expansion and non-expansion [&hellip

NAUH Weighs in on American Health Care Act

In a letter to members of Congress and selected congressional staff, NAUH shared its perspective on the American Health Care Act, the legislation Congress is considering as a means of repealing and replacing the Affordable Care Act.  The letter highlights several aspects of the proposed law NAUH appreciates and points to aspects with which it disagrees, including its failure to restore Medicare DSH payments to pre-Affordable Care Act levels, its continuation of Medicaid DSH cuts in Medicaid expansion states for two more years, and a methodology for indexing future growth in the program’s spending that NAUH believes will leave Medicaid [&hellip

MACPAC Points to March Medicaid DSH Report to Congress

Required to report annually to Congress on the state of the Medicaid program, members of the Medicaid and CHIP Payment and Access Commission reviewed drafts of their proposed March report to Congress at the agency’s January meeting in Washington, D.C. In its draft report MACPAC addresses the Medicaid disproportionate share hospital payment program (Medicaid DSH), including DSH allotments, their relationship to the number of uninsured people, the amount and sources of hospital uncompensated care costs, and the impact of Medicaid DSH on hospitals that provide especially large amounts of uncompensated care while also providing essential community services. The draft MACPAC [&hellip

MACPAC Meets, Discusses Medicaid DSH Issues

Last week the Medicaid and CHIP Payment and Access Commission met in Washington, D.C. to review aspects of its required March report to Congress and to address other Medicaid and CHIP issues. Included on the agenda of the meeting were: a review of chapters of the March report on Medicaid disproportionate share (Medicaid DSH) and monitoring of access to care; alternative approaches to state financing of their Medicaid programs; Medicaid coverage for low-income adults; and Medicaid program integrity issues. MACPAC’s efforts, although not binding on the administration, carry a great deal of weight with those institutions.  In addition, they are [&hellip

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