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CMS Releases Proposed Rule on Medicaid DSH Cuts



This week in Washington—CMS released its proposed rule for implementing the Medicaid DSH cuts. You are tuning in to the National Association of Public Hospitals and Health Systems health policy update for the week of May 13, 2013.

On May 13, the federal Centers for Medicare & Medicaid Services (CMS) released a proposed rule implementing the Affordable Care Act’s (ACA’s) Medicaid disproportionate share hospital (DSH) cuts. The ACA included cuts to the Medicaid DSH program totaling $18.1 billion beginning in fiscal year (FY) 2014 through FY 2020. In the proposed rule, CMS provides details on the DSH health reform methodology that the agency will use to determine the amount of reduction to each state’s DSH allotment for FYs 2014 and 2015. Specifically, the DSH health reform methodology will incorporate five factors: an adjustment factor to account for low-DSH states, an uninsured percentage factor, a high Medicaid volume factor, a high uncompensated care cost factor, and an adjustment factor to account for certain waiver states that used DSH funds for expansion.

NAPH is evaluating the proposal and will provide detailed analyses to members in the coming days and weeks. For questions, please contact Xiaoyi Huang, assistant vice president, at or (202) 585-0127. Comments on the proposed rule are due July 12.

Thanks for listening to another edition of This Week in Washington. I’m Zina Gontscharow; join us next week for another update.



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