Archive for Medicaid DSH

 

Congress Gives Hospitals Medicaid DSH Relief

Medicaid DSH allocations to states will not be reduced right away thanks to a new continuing resolution to fund the federal government through December 11.

The Medicare disproportionate share allocation cuts to the states, mandated by the Affordable Care Act but delayed by Congress several times, were delayed again earlier this year but scheduled to take effect on November 11.  With the latest continuing resolution, the cuts will be delayed yet another month.

Learn more about the delay of Medicaid DSH cuts and other aspects of the continuing resolution that affect hospitals in the Healthcare Dive article “Providers win Medicare loan extension, DSH relief but lose other asks in stop-gap spending law.”…

Coronavirus Update for Wednesday, September 23

The following is the latest COVID-19 information from the federal government as 2:30 p.m. on Wednesday, September 23.

Continuing Resolution to Fund the Federal Government

The House has passed, and the Senate is expected to take up and pass as soon as this week, a continuing resolution to fund the federal government from the beginning of the new fiscal year, on October 1, through December 11; the president is expected to sign the measure.  Key health care provisions in this continuing resolution include:

  • Changes in the Medicare Accelerated and Advance Payment Program that extend the period before repayment begins and the period before the balance must be repaid in full; reduce the recoupment percentage; and lower the interest rates for this and comparable programs.
  • A delay in the Affordable Care Act-mandated reduction of Medicaid disproportionate share (Medicaid DSH) allotments to the states through December 11.
  • Extended funding for Community Health Centers, the National Health Services Corps, and the Teaching Health Centers Graduate Medical Education Program through December 11.
  • Extended funding for the Special Diabetes Program through December 11.
  • Extended authorization for the certified community behavioral health clinics demonstration program through December 11.
  • Clarification that drugs and biologicals used for medication-assisted

CMS Provides Guidance on Medicaid DSH Calculations

State Medicaid program accounting for hospital uncompensated care when calculating hospital-specific Medicaid disproportionate share limits is the subject of new guidance from the Centers for Medicare & Medicaid Services.

In the guidance, the Centers for Medicare & Medicaid Services explains that because of several court rulings, states can decide for themselves whether to offset third-party payer payments from costs in their Medicaid DSH calculations for periods prior to June 2, 2017 but that beginning with that date,  CMS will enforce its own interpretation of the policy.

In new guidance, CMS presents two methodologies for accounting for its mid-year policy change and reminds stakeholders about its new methodology for calculations after June 2, 2017.  Learn more from this Medicaid notice and from its accompanying CMS informational bulletin “Treatment of Third Party Payers (TPP) in Calculating Uncompensated Care Costs (UCC).”

MFAR Backlash Continues

Diverse health care and government interests are rallying around their opposition to the proposed Medicaid fiscal accountability rule.

The regulation, proposed by the Centers for Medicare & Medicaid Services in November, would impose new limits on the ability of states to finance their share of their Medicaid spending, potentially jeopardizing provider payments and the ability of high-volume Medicaid providers to operate without suffering great losses.

In all, CMS received more than 4200 written comments in response to the proposed regulation, most of them expressing opposition.  Among those doing so were state governments, the National Governors Association, hospitals and hospital associations, nursing home operators, and health advocacy organizations.  Also among them were DeBrunner & Associates clients the National Alliance of Safety-Net Hospitals, the Safety-Net Association of Pennsylvania, Private Essential Access Community Hospitals (PEACH), the Coalition of Long-Term Acute-Care Hospitals, the University of Pennsylvania Health System, Post Acute Medical, and others.  Also questioning the proposed changes was the National Association of Medicaid Directors, whose executive director questioned the constitutionality of the proposal.

Learn more about the Medicaid fiscal accountability rule, what it seeks to do, and why so many oppose in the Stateline article “Medical Groups Slam Trump Medicaid

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C.

The following is MACPAC’s own summary of the sessions.

The Medicaid and CHIP Payment and Access Commission kicked off its December meeting with highlights from its forthcoming issue of MACStats: Medicaid and CHIP Data Book, due out December 18, 2019. MACStats brings together statistics on Medicaid and State Children’s Health Insurance Program (CHIP) enrollment and spending, federal matching rates, eligibility levels, and access to care measures, which come from multiple sources.

Later the Commission discussed a proposed rule that the Centers for Medicare & Medicaid Services issued in November, which—among other changes—would increase federal oversight of Medicaid supplemental payments. The final morning session addressed payment error rates in Medicaid, with a briefing on the annual Department of Health and Human Services Agency Financial Report (AFR). Fiscal year 2019 was the first time that the AFR incorporated eligibility errors since the Patient Protection and Affordable Care Act’s Medicaid eligibility and enrollment changes took effect in 2014.

After lunch, MACPAC staff summarized themes from expert roundtables convened in November, one to explore Medicaid policy on high-cost specialty drugs and another on the need for more