Noteworthy News

Archive for January, 2013


NAUH Projects Hospital DSH Losses

The National Association of Urban Hospitals (NAUH) has developed a model that projects how much Medicare disproportionate share (Medicare DSH) revenue individual hospitals may lose beginning in FY 2014 under the terms of the Affordable Care Act. That model shows that many private, non-profit urban safety-net hospitals will lose more than $1 million in Medicare DSH revenue in FY 2014 alone. According to the 2010 health reform law, Medicare DSH payments are to be cut 75 percent, with some of this reduction to be redistributed to hospitals based on how much uncompensated care they provide. When consultants to the Centers [&hellip

South Carolina to Cut Medicaid Payments to Urban Hospitals

South Carolina’s Medicaid program will reduce Medicaid payments to the state’s urban hospitals so it can increase payments to rural hospitals. The new policy, to take effect next year, will shift $20 million in payments from urban to rural hospitals. “We’ve long known that rural hospitals face challenges that larger hospitals don’t, and now, for the first time ever, the state of South Carolina is going to treat them that way, “ Governor Nikki Haley explained during her state-of-the-state address. The state’s Medicaid director elaborated, noting that “The smaller hospitals have suffered at the hands of the bigger hospitals for [&hellip

Greater Cost-Sharing in Medicaid’s Future?

States would be permitted to require greater cost-sharing from Medicaid recipients under a new regulation proposed by the federal Centers for Medicare & Medicaid Services (CMS). The proposed regulation, which also addresses matters involving state Children’s Health Insurance Programs (CHIP) and health insurance exchanges, would permit states to impose increased co-pays for non-emergency use of hospital emergency rooms and for non-preferred prescription drugs.  The cost-sharing for non-emergency use of emergency rooms would be limited to eight dollars for Medicaid recipients with incomes between 100 percent to 150 percent of the federal poverty level but would have no limit for those [&hellip

How Hospitals Staved Off Threatened Fiscal Cliff Cuts

Hospitals were spared three of the major Medicare cuts they feared most in the fiscal cliff solution – bad debt reimbursement, graduate medical education payments, and outpatient evaluation and management (E&M) fees – through vigorous lobbying of Congress. As the fiscal cliff deadline drew nearer, according to the publication Politico, hospital associations, ad hoc coalitions of providers, and individual hospitals communicated directly with their members of Congress and deployed their lobbyists to make their case to Congress.  Consequently, while hospitals did suffer some Medicare cuts in the fiscal cliff solution, they were spared the cuts they feared the most. And [&hellip

Next Up in ACA Implementation

A new policy brief from George Washington University’s Hirsh Health Law and Policy Program and the Robert Wood Johnson summarizes some of the key aspects of the 2010 health care reform law that will continue in the coming year. Among the issues the article addresses that are of particular importance to urban safety-net hospitals are premium subsidies and cost-sharing assistance; Medicaid expansion, eligibility, and enrollment simplification, disproportionate share payments (Medicaid DSH), and federal assistance to state Medicaid programs; Medicare payment reform; community health center expansion; and the community benefit responsibilities of non-profit hospitals. Read about these and other reform-related subjects [&hellip

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