In a letter organized with help from America's Essential Hospitals, a bipartisan group of lawmakers call on Senate leaders to avert a devastating, $8 billion cut to Medicaid disproportionate share hospital (DSH) funding on Oct. 1. The letter follows a similar communication to House leaders.

House panels last week heard testimony on a variety of issues important to essential hospitals, including looming cuts to Medicaid disproportionate share hospital funding, workforce shortages and training, and the 340B Drug Pricing Program.

The association urged CMS to work with Congress to avoid unintended cuts to Medicaid disproportionate share hospital payments imposed by Section 203.

The Supporting Safety Net Hospitals Act would eliminate devastating cuts to Medicaid disproportionate share hospital funding in fiscal years 2024 and 2025.

The report reviews how COVID-19 public health emergency policies affected hospital finances and includes state-specific projections for the Medicaid disproportionate share hospital funding cuts scheduled to take effect Oct. 1.

More than 70 Policy Assembly attendees visited congressional offices to share association priorities, including eliminating $16 billion in Medicaid DSH cuts over the next two fiscal years, protecting the 340B Drug Pricing Program, and establishing a federal designation for essential hospitals.

CMS proposes to limit the types of Medicaid Section 1115 waiver days that can be included when calculating a hospital’s disproportionate patient percentage.

The proposed rule implements Section 203, which alters the process for calculating the Medicaid disproportionate share hospital uncompensated care limit.

In a new podcast series by a physician at association member NYC Health + Hospitals, Beth Feldpush, DrPH, the association's senior vice president of policy and advocacy, unpacks the complex patchwork of payments that keep essential hospitals afloat. 

In an annual report to Congress, the Medicaid and CHIP Payment and Access Commission finds an increase from 2018 to 2019 in the number of uninsured and in charity care and bad debt. The report includes state-specific projections of the Medicaid disproportionate share hospital allotment.

The guidance clarifies how hospitals receiving Medicaid disproportionate share hospital payments can use Provider Relief Fund general and targeted distribution payments.

In its March report to Congress, the Medicaid and CHIP Payment and Access Commission included chapters analyzing Medicaid disproportionate share hospital payments, state readiness to report on core quality measure sets, and Section 1115 waiver evaluations.

Congress approved and the president signed a fiscal year 2020 spending package that delays through May 22, 2020, a $4 billion cut to Medicaid disproportionate share hospital payments.

Congress will focus on the looming deadline to fund the federal government and address the $4 billion cut to Medicaid disproportionate share hospital funding.

President Trump signed a short-term continuing resolution delaying disproportionate share hospital funding cuts to Nov. 22; House Speaker Pelosi launched an impeachment inquiry.

Lawmakers must act before Oct. 1 to stop the $4 billion cut to Medicaid disproportionate share hospital payments, extend expiring health care programs, and fund government operations for fiscal year 2020.

The ruling reinstates a 2017 final rule requiring that audits include payments from Medicare and commercial payers when calculating the hospital-specific disproportionate share hospital funding limit.

In a May 17 Capitol Hill briefing, leaders from NYC Health + Hospitals, East Alabama Medical Center, and Eskenazi Health shared how disproportionate share hospital funding sustains their hospitals.

A federal court in Washington, D.C., vacated a final rule requiring Medicaid disproportionate share hospital limit calculations to include Medicare and commercial insurance payments; the court explicitly issued a decision with nationwide impact.

The association continues to work with congressional leadership and staff to ensure a delay of Medicaid disproportionate share hospital cuts is included in the next funding measure; Senate confirms new Health and Human Services Secretary.

The measure passed by Congress and signed by President Trump Monday funds the government through Feb. 8 and extends the Children's Health Insurance Program six years, but leaves unresolved a delay of Medicaid disproportionate share hospital cuts.

As Congress focuses on Jan. 19 funding deadline, America's Essential Hospitals continues pressure to delay Medicaid disproportionate share hospital cuts. The Trump administration releases guidance on work requirements for Medicaid recipients.

The association launched an advocacy and media campaign calling on Congress to delay Medicaid disproportionate share hospital payment cuts as part of a long-term government funding measure.

Congress returns from recess to focus on long-term solutions after passing a short-term bill to fund the government through Jan. 19; lawmakers push for delay of 340B Drug Pricing Program cuts.

The bill delays disproportionate share hospital payment cuts for two years; House Republicans consider repealing the individual mandate through tax reform.

In a Nov. 2 Federal Register notice, the Centers for Medicare & Medicaid Services posted final DSH allotments for FY 2015 and preliminary allotments for FY 2017.

Senate and House bills to fund the Children's Health Insurance Program are similar, but the House version includes a one-year delay of Medicaid disproportionate share hospital cuts.

Hospitals use the worksheet S-10 to submit uncompensated care data to the Centers for Medicare & Medicaid Services; the agency will begin using the worksheet to calculate Medicare disproportionate share hospital payments in fiscal year 2018.

The federal fiscal year came to a close Sept. 30, ending a nearly yearlong congressional effort to repeal and replace the Affordable Care Act and bringing tax reform efforts and other health care priorities to the forefront in Congress.

Congress aims to pass legislation by Sept. 30 to stabilize the Affordable Care Act (ACA) insurance markets and reauthorize several health care programs; three senators plan to unveil new ACA repeal legislation.

The proposed reductions are set to take effect Oct. 1; the association recommended the Centers for Medicare & Medicaid Services protect state disproportionate share hospital payment allotments from total elimination, among other suggestions.

Substantial cuts to Medicaid disproportionate share hospital payments are set to begin on Oct. 1; strong and immediate input from essential hospitals is vital to successfully secure another delay.

The newly released set of frequently asked questions relates to potential payment issues for Medicaid managed care patients in institutions for mental disease.

The new rule would affect inpatient operating payments, Medicare disproportionate share hospital payments, and the Hospital Readmissions Reduction Program.

Senate committees will focus on market stabilization legislation and Children’s Health Insurance Program (CHIP) reauthorization; the association seeks to attach to the CHIP bill a delay of Medicaid disproportionate share hospital payment cuts.

In the rule, the Centers for Medicare & Medicaid Services proposes a disproportionate share hospital (DSH) health reform methodology to determine each state’s DSH allotment reduction for each fiscal year.

Courts in Minnesota, Tennessee, and Virginia have ruled in favor of hospitals challenging the Center for Medicare & Medicaid Services' inclusion of Medicare and commercial payments in the calculation of disproportionate-share hospital payment limits.

The brief projects Medicaid disproportionate share hospital payment reductions under the Affordable Care Act and the House-passed American Health Care Act.

America’s Essential Hospitals encourages CMS to improve transparency, risk adjust, and reduce regulatory burden for essential hospitals.

A white paper calls for a stop to impending cuts to Medicaid disproportionate share hospital (DSH) payments and recommends modernizing existing DSH policy.

It requires Medicare payments for beneficiaries dually eligible for Medicaid, and other third-party payments be included in uncompensated care calculations.

CMS finalizes the agency's interpretation that, in determining hospital-specific DSH payment limits, the total costs of care for Medicaid inpatient and outpatient services must account for all third-party payments.

House GOP leadership pulled the bill due to inadequate support; the association now resumes its focus on other hospital-related issues, including DSH cuts.

MACPAC's March report includes analysis on Medicaid DSH and impacts of the ACA on hospitals, as well as recommendations for the future of CHIP.

The House plan to repeal and replace the Affordable Care Act would rescind Medicaid disproportionate share hospital cuts and impose per-capita caps on Medicaid funding.

The notice contains state-specific, final FY 2014 disproportionate share hospital allotments, without reductions that would have been imposed under the ACA.

Hospitals eligible for the essential community providers list are participants in the 340B and DSH programs, critical access hospitals, and others.

The agency analyzed how subsets of hospitals, including those defined as a safety net, performed in the overall hospital star rating system.

The rule maintains a prohibition against direct payments by states to providers for services delivered under managed care contracts and explicitly prohibits states from directing plan expenditures.

A new proposed rule for Medicare’s Inpatient Prospective Payment System would reverse the controversial two-midnight policy payment cut and make numerous other policy and payment changes, including to quality reporting programs.

Rule includes a net increase in IPPS payment rates of 0.9 percent, Medicare DSH cuts of $1.2 billion in FY 2016, and updates to the HAC Reduction, Hospital VBP, IQR, and EHR Incentive programs.

Member panel will exchange information, advise association on recent CMS proposal to restrict states' ability to direct supplemental payments; please express interest by July 17.

Report suggests financial incentive for hospitals to prescribe 340B drugs, a claim America's Essential Hospitals calls unfounded and troubling.

Comments caution CMS about Medicare DSH payment cuts and urge CMS to ensure measures and methodologies used in quality reporting programs are adjusted for sociodemographic factors.

GAO found that CMS lacks adequate data to conduct provider-level oversight of Medicaid payments to ensure payments are used for Medicaid patients in an economical and efficient manner.

A district court has granted a preliminary injunction restricting HHS and CMS from altering the hospital-specific DSH limit without following notice-and-comment procedures.

Agency reverts to position recommended by America's Essential Hospitals to define uninsured status at the service level for purposes of calculating DSH payments; sets Dec. 31 as start of new policy

Plans include evaluating potential data sources, constructing an operational model to estimate state-level DSH allocations, and consulting with stakeholders throughout the process.

The definition would be used for determining Medicaid DSH costs. Association urges policy that accurately captures the actual burden of uncompensated care, particularly before DSH cuts and recoupment based on DSH audits begin.

Comments cover topics such as Medicare disproportionate share hospital payment cuts and risk adjustment for socioeconomic status.

A recent study found that planned reductions in Medicaid DSH payments and ongoing inflation in health care costs will cause debilitating gaps in funding for essential hospitals. Expected system costs to states that do not expand Medicaid will be exacerbated by continued uncompensated care costs and no additional Medicaid funds to offset them.

Providers with pending appeals on the number of Medicaid eligible days used in the calculation of the Medicaid fraction of their disproportionate patient percentage must provide supporting information and documentation to the PRRB by July 22.

Budget bill eliminates FY 2014 Medicaid DSH cuts, delays FY 2015 cuts

House votes to restore some DSH funding. SGR bill directs HHS to monitor DSH need

Medicare DSH payments compensate hospitals for costs associated with low-income patient care

The rule outlines reporting and cost parameters for states and individual hospitals

Held nearly 100 meetings, educated Congress about work to ensure patient access to high quality care

Siegel, Gremminger highlighted the importance of delaying, reconsidering scheduled Medicaid DSH cuts

Rule implements the Affordable Care Act's Medicaid DSH cuts for fiscal years 2014 and 2015

Rule outlines CMS' methodology for annual reductions to DSH payments

Talk focused on insurance coverage expansion activities and impact on essential hospitals

Analysis from the Kaiser Family Foundation Commission on Medicaid and the Uninsured found that 6.4 million people will miss out on insurance coverage if the 21 states not intending to expand their Medicaid program and the six undecided states do not implement the Medicaid expansion.

Urges CMS to incentivize states to target DSH at hospitals with high levels of uncompensated care and Medicaid patients

Calculation will determine reduction to each state's DSH allotment for FYs 2014 and 2015

Rule proposes implementation of the Affordable Care Act's Medicaid DSH cuts

Rule includes proposed formula to make Medicare DSH reductions under ACA

Includes important changes to Medicaid and Medicare of interest to association members

Legislation did not cut Medicaid provider taxes, Medicare E&M, but targeted hospitals in other ways