Medicaid DSH

Medicaid DSH Cut Delayed

Cuts in Medicaid DSH payments to hospitals will be delayed for another month after Congress passed, and the president signed, a continuing resolution to fund the federal government through December 20. A cut in federal Medicaid disproportionate share (Medicaid DSH) allotments to the states is mandated by the Affordable Care Act and has been delayed several times by Congress.  If implemented, Medicaid DSH allotments to the states would be slashed $4 billion in FY 2020 and then $8 billion a year through FY 2025. Cuts in allotments to the states would result in reductions of Medicaid DSH payments to DSH-eligible [...]

Verma Addresses Medicaid Issues

Earlier this week, Centers for Medicare & Medicaid Services administrator Seema Verma spoke at a conference of the National Association of Medicaid Directors. In addition to discussing a proposed regulation posted earlier in the day that would introduce changes in the regulation of state financing of their Medicaid programs, Verma also addressed: Medicaid demonstration programs Medicaid work requirements a shift toward value-based payments better coordination of care for the dually eligible (individuals serve by both Medicaid and Medicare) enrollment issues improvements in the efficiency of the federal Medicaid bureaucracy Read Verma’s complete remarks here.

MACPAC Posts Meeting Transcript

The Medicaid and CHIP Payment and Access Commission met in Washington, D.C. earlier this month.  The issues on MACPAC’s agenda were: state readiness to report mandatory core set measures analysis of buprenorphine prescribing patterns among advanced practitioners in Medicaid Medicaid’s statistical information system (T-MSIS) Medicaid disproportionate share hospital payment (Medicaid DSH) allotments Medicaid policies related to third-party liability Medicaid and maternal health A transcript of the MACPAC meeting is now available.  Find it here.  

MACPAC Looks at Medicaid DSH

At a time when cuts in Medicaid disproportionate share hospital payments (Medicaid DSH) are still scheduled for the current fiscal year and some in Congress are calling for a new approach to allotting DSH funds among the states, the Medicaid and CHIP Payment and Access Commission has released its annual analysis of Medicaid DSH allotments to the states. The report includes: data about changes in the uninsured rate demographic information about the uninsured information about the cost of hospital uncompensated care perspectives on hospital Medicaid shortfalls a comparison of hospital uncompensated care costs when calculated using different methodologies data about [...]

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 Commission devoted its Thursday morning discussion to integration of care for beneficiaries who are dually eligible for Medicaid and Medicare. Panelists Amber Christ, directing attorney at Justice in Aging; Griffin Myers, chief medical officer at Oak Street Health; and Michael Monson, senior vice president for Medicaid and complex care at Centene, presented beneficiary, provider, and health plan perspectives and a question and answer session followed. After lunch, MACPAC staff briefed the Commission on [...]

Safety-Net Hospitals Gird for Loss of Medicaid DSH Money

Safety-net hospitals and others will lose a significant portion of their Medicaid disproportionate share (Medicaid DSH) payments on November 22 unless Congress delays implementation of the cut in those payments that was mandated by the Affordable Care Act. And hospitals that receive these payments are now preparing for the worst. The Medicaid DSH cut was included in the 2010 health care reform law in anticipation of a great reduction in the number of uninsured people leaving hospitals providing much less uncompensated care and therefore not in need of as much DSH money.  The law’s reach has not proven to be [...]

CMS Adopts Methodology for Medicaid DSH Cuts

Medicaid DSH money will be allocated among states based on a new methodology under a regulation adopted this week by the Centers for Medicare & Medicaid Services. But it is not clear when that new methodology may actually be used. Cuts in Medicaid disproportionate share hospital (Medicaid DSH) allotments to states were mandated by the Affordable Care Act based on the expectation that the law would greatly reduced the number of uninsured Americans.  While this has been the case, the decline in the number of uninsured has not been as great as expected.  For this reason, Congress has on several [...]

Senate Finance Committee Reports on Supplemental Medicaid Payments

The majority members of the Senate Finance Committee have published a report on supplemental Medicaid payments. According to the new document, This report seeks to increase educational understanding of Medicaid supplemental payments, as well as outline the reporting mechanisms for these payments to ensure adequate stewardship of taxpayer dollars.  The report consists of descriptions of the different types of supplemental Medicaid payments that states make to some providers, including: Medicaid disproportionate share payments (Medicaid DSH) non-DSH payments upper-payment limit payments (UPL payments) demonstration supplemental payments medical education payments It also describes the magnitude of these payments, noting that supplemental Medicaid [...]

MACPAC Recommends Changes in Medicaid Shortfall Definition

Hospitals’ calculation of their Medicaid shortfall would change under a recommendation that MACPAC voted to make to Congress.  That change, in turn, could affect hospitals’ future Medicaid disproportionate share payments. Last week the Medicaid and CHIP Payment and Access Commission voted overwhelmingly to change how hospitals calculate their Medicaid shortfall:  the difference between what they spend caring for their Medicaid patients and what Medicaid pays them for that care.  Under MACPAC’s proposal, hospitals would need to deduct from their shortfall total all third-party payments they receive for the care they provide to their Medicaid patients. If this proposal were to [...]

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 Commission wrapped up its work on the June 2019 Report to Congress on Medicaid and CHIP at the April meeting, with sessions reviewing four of the report’s five draft chapters on Thursday morning, and votes on potential recommendations later in the afternoon. First on Thursday’s agenda was a draft June chapter on Medicaid prescription drug policy, which contained draft recommendations to provide states with a grace period to determine Medicaid drug coverage and [...]

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