Noteworthy News

Fiscal Cliff Poses Threat to Urban Safety-Net Hospitals

Congress and the Obama administration are now negotiating possible solutions to the fiscal cliff crisis.

A number of the solutions that have been discussed in the recent past would pose especially major problems for urban safety-net hospitals.  Those “solutions” include:

  • further reductions in annual Medicare updates
  • reductions in hospitals’ Medicare outpatient evaluation and management (E&M) fees
  • further reductions in Medicare bad debt reimbursement
  • new limits on the provider taxes states can levy to finance their Medicaid program
  • further reductions in Medicaid disproportionate share (Medicaid DSH) payments
  • a reduction in the rate at which the federal government matches states’ share of Medicaid spending (the federal medical assistance percentage, or FMAP)
  • delayed implementation of the Affordable Care Act’s Medicaid expansion

As these negotiations continue, members of the National Association of Urban Hospitals (NAUH) will remind their congressional delegations that such cuts could have disastrous implications for the nation’s private, non-profit urban safety-net hospitals.


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