America’s Essential Hospitals urged the Centers for Medicare & Medicaid Services (CMS) to issue a final rule that would define uninsured at the service level (instead of the patient level) for purposes of determining allowable costs for the Medicaid disproportionate share hospital (DSH) program. In a letter sent August 28, the association encouraged CMS to accurately and fairly capture the actual burden of uncompensated care and to mitigate negative impacts due to the delay in issuing this final rule.
When CMS issued the proposed rule in January 2012, states were working on audits for fiscal year (FY) 2009. Now states are auditing FY 2011 payments, the first year of results that CMS will use to recoup payments made in excess of hospitals’ DSH limit. Given the delay in issuing the final rule, the association urged CMS to mitigate negative impacts resulting from any disallowance linked to policy changes resolved by finalizing this rule. Specifically, the association asked CMS to either not pursue disallowances or reduce disallowances for FY 2011.
Please contact Xiaoyi Huang, JD, director of policy, at firstname.lastname@example.org or 202.585.0127, with questions.