House and Senate lawmakers are advancing proposals requiring site-neutral payments for hospital outpatient services. Now is the best time to tell your congressional delegations how these policies will affect your hospital.

We urge Congress to protect access to care for the most vulnerable communities and not enact further hospital site-neutral payment proposals, which would disproportionately and negatively impact essential hospitals.

Unless Congress acts, a devastating, $8 billion cut to Medicaid disproportionate share hospital (DSH) funding will occur Oct. 1. Help us stop this cut by adding your essential hospital to a sign-on letter urging congressional leaders to act quickly.

Proposed rules for Medicare’s OPPS and PFS for calendar year 2024 would maintain full Medicare Part B drug payment to hospitals in the 340B Drug Pricing Program, revise site-neutral payment policies, and amend price transparency policies, among other changes.

The Centers for Medicare & Medicaid Services proposes to remedy nearly five years of unlawful Part B cuts to hospitals in the 340B Drug Pricing Program with $9 billion in lump-sum Outpatient Prospective Payment System payments.

Hospitals face a 25 percent reduction in Medicare payments if they fail to meet the new equity standards or regulations mandated by the Centers for Medicare & Medicaid Services under the Inpatient Quality Reporting Program.

This legislation effectively postpones the debt ceiling issue for two years, dispelling concerns of a potential financial catastrophe. This Action Update summarizes the legislation and provisions of interest to essential hospitals.

The proposed rules are part of CMS’ response to executive orders directing federal agencies to review existing guidance for opportunities to strengthen and improve access to health care coverage, including through Medicaid.

The proposed rule changes directed payment policy; access standards and monitoring; in lieu of service and setting requirements; medical loss ratio policy and reporting; and quality strategies, improvements, and reviews.

If CMS finalizes the proposed rule, DACA recipients would be eligible to apply for coverage through the health care marketplaces, Basic Health Programs, and some Medicaid and Children’s Health Insurance Programs.

Please urge your House members now to support H.R. 2665, the Supporting Safety Net Hospitals Act, which eliminates two years of looming Medicaid disproportionate share hospital cuts for fiscal years 2024 and 2025.

The agency encourages states to leverage a new Section 1115 demonstration to implement a service delivery system that facilitates reentry transitions for Medicaid-eligible individuals leaving prisons and jails.

The proposal includes numerous policy and payment changes to Medicare’s Inpatient Prospective Payment System for fiscal year 2024, including a 2.8 percent increase in inpatient payment rates.

The agency proposes to limit the types of patient days associated with Section 1115 waivers that are included in the Medicaid fraction of the hospital’s disproportionate patient percentage.

The proposed rule implements Section 203 of the 2021 Consolidated Appropriations Act, altering the rules for considering the costs and payments associated with Medicare and commercial dually eligible patients when calculating a hospital’s Medicaid DSH uncompensated care limit.

Unless Congress acts, $32 billion in DSH cuts over the next four years will undermine essential hospitals and could push some to the brink. The scheduled DSH cuts include an $8 billion reduction on October 1, 2023 — more than two-thirds of all federal DSH spending annually.

Our proposal would codify a designation of essential hospitals in statute, allowing lawmakers to better target support to improve access to care and public health.

The 340B program continues to work as Congress intended. America’s Essential Hospitals urges Congress and the administration to protect the 340B program and ensure all stakeholders comply with the law.

The $1.66 trillion package would extend funding for government operations through Sept. 30, 2023, including $120.7 billion for the Department of Health and Human Services, $9.9 billion more than the FY 2022 enacted level, and numerous provisions important to essential hospitals.

The proposed rule updates essential community provider requirements for qualified health plans and adds a special enrollment period for those disenrolled from Medicaid or CHIP.

Changes in the proposed rule seek to improve care coordination among providers and increase protections for substance use disorder patients to mitigate discrimination during treatment.

Citing policy and operational challenges with implementing the administrative dispute resolution process as created in a 2020 final rule, HRSA proposes a less formal ADR process that it believes will be less burdensome for parties submitting claims.

Hospitals that fill a safety net role need targeted funding to remain on the front lines of public health emergencies and serve the nation’s most underrepresented patients and marginalized communities.

The United States faces a significant and pervasive health care workforce shortage, especially in underserved communities. As policymakers discuss how to address current and future workforce shortages, we urge Congress to expand, protect and fund the health care workforce.

As Congress continues to consider legislation during and after the pandemic, it should make permanent policies that allow providers to expand access to care, including telehealth and hospital-at-home, to improve the health of their communities.

The final rule for calendar year 2023 continues certain flexible telehealth policies, overhauls the Medicare Shared Savings Program, and revises the Quality Payment Program.

The final rule reverses Medicare Part B drug payment cuts to hospitals in the 340B Drug Pricing Program, continues site-neutral payment policies, and revises the inpatient-only list, among other proposed changes.

The new final rule narrows the types of benefits considered in public charge determinations by excluding nonemergency Medicaid and other in-kind benefits that were in the 2019 final rule.

A federal district court ruled that HHS must pay hospitals in the 340B Drug Pricing Program the full Medicare Part B drug payment rate for the remainder of calendar year 2022.