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MedPAC Offers DSH, 340B Recommendations

The Medicare Payment Advisory Commission has recommended that Congress direct changes in the 340B prescription drug discount program and in the manner in which Medicare makes disproportionate share hospital payments (Medicare DSH). In its annual report to Congress, MedPAC recommended a reduction in 340B prescription drug payments to hospitals. The proposed reduction would cut 340B program spending approximately $300 million. MedPAC then recommended that those 340B savings be redirected to the Medicare DSH uncompensated care pool. And it also called for distributing the money in that pool based on better data on the uncompensated care hospitals provide, as reported on [&hellip

DSH/340B Hospitals Have Lower Medicare Drug Costs

Medicare disproportionate share (Medicare DSH) hospitals that qualify for the federal 340B prescription drug discount program have lower Medicare Part B drug costs than other Medicare providers. So concludes a new study performed for 340B Health, an association that represents more 1100 public and non-profit hospitals and health systems that participate in the 340B drug pricing program. According to the organization 340B Health, Medicare pays disproportionate share hospitals in the 340B drug discount program on average 13 percent less for separately payable drugs reimbursed through Medicare Part B. This is in comparison to what it pays other hospitals and physician [&hellip

NAUH Urges MedPAC to Reconsider Medicare DSH Proposal

At their December meeting, members of the Medicare Payment Advisory Commission discussed the possibility of recommending to the Centers for Medicare & Medicaid Services that Medicare calculate a portion of eligible hospitals’ Medicare disproportionate share hospital payments (Medicare DSH) using the Medicare cost report’s S-10 form. That form seeks to capture how much uncompensated care hospitals provide. NAUH has long opposed the use of the S-10 to calculate the uncompensated care portion of Medicare DSH payments and wrote to MedPAC asking the commissioners not to make such a recommendation to CMS. In making this argument, NAUH cited the lack of [&hellip

MedPAC Addresses Major Issues for Urban Safety-Net Hospitals

The independent federal agency that advises Congress on Medicare payment issues discussed several issues of great importance to urban safety-net hospitals at its December 10 meeting in Washington, D.C. During the course of a discussion about FY 2017 Medicare inpatient and outpatient payment increases, the commissioners of the Medicare Payment Advisory Commission (MedPAC) also considered staff recommendations that would alter the section 340B prescription drug discount program and Medicare disproportionate share hospital payments (Medicare DSH). Medicare DSH and the 340B program are essential to private, non-profit urban safety-net hospitals. NAUH members have received a memo describing the proposals MedPAC commissioners [&hellip

One State’s Battle With DSH Cuts

Hospitals across the country are concerned about the degree to which the Affordable Care Act is reducing the Medicare disproportionate share hospital (Medicare DSH) payments that help underwrite the cost of the care they provide to uninsured patients. Those in states that have expanded their Medicaid programs are now receiving payments for at least some of those formerly uninsured patients because those individuals are now enrolled in Medicaid. In states that did not expand their Medicaid programs, however, hospitals face challenges coming from two directions: reduced Medicare DSH payments without the benefit of some of those uninsured patients enrolling in [&hellip

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