Medicare disproportionate share

CMS Proposes Regulation Governing Medicare DSH

The Centers for Medicare & Medicaid Services has proposed altering its regulations governing the calculation of eligible hospitals’ Medicare disproportionate share payments (Medicare DSH). According to CMS, This proposed rule would revise our regulations on the counting of days associated with individuals eligible for certain benefits provided by section 1115 demonstrations in the Medicaid fraction of a hospital's disproportionate patient percentage. This is essentially the same change CMS included in its proposed FY 2022 and FY 2023 inpatient prospective payment system rules and then did not adopt in the final rule. In proposing this change again CMS suggests that this [...]

iqtsupport2023-03-01T06:00:58-05:00March 1, 2023|Centers for Medicare & Medicaid Services, Medicare, Medicare disproportionate share, Medicare DSH, Medicare regulations|

Federal Health Policy Update for January 12

The following is the latest health policy news from the federal government for January 6-12. Some of the language used below is taken directly from government documents. Renewal of COVID-19 Public Health Emergency Declaration HHS Secretary Xavier Becerra has signed an order extending the previous declaration of a COVID-19 public health emergency. This declaration extends the emergency to April 11. The administration continues to assure stakeholders it will provide 60 days’ notice prior to the end of the public health emergency. MedPAC Medicare Rate Recommendations Every year MedPAC recommends to Congress rate increases for the different kinds of health care [...]

iqtsupport2023-01-12T19:22:04-05:00January 12, 2023|Centers for Medicare & Medicaid Services, COVID-19, Medicaid, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|

Federal Health Policy Update for October 6

The following is the latest health policy news from the federal government for the week of September 26 to October 6. Some of the language used below is taken directly from government documents. 340B HHS must immediately end its significant cut in reimbursement for 340B-covered prescription drugs provided on an outpatient basis to eligible patients, a federal court has ruled, writing that “The prospective portion of the 2022 reimbursement rate shall be vacated because it is defective and because vacating this portion of the 2022 OPPS Rule will not cause substantial disruption” and that “HHS should not be allowed to [...]

iqtsupport2022-10-06T17:42:49-04:00October 6, 2022|340b, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, Medicaid, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|

Court Rejects Long-Running Medicare DSH Challenge

In a case that challenged a 2005 change in how the federal Centers for Medicare & Medicaid Services calculates Medicare disproportionate share (Medicare DSH) payments, the Supreme Court has, in a 5-4 decision, reversed a lower court ruling and upheld CMS’s policy of counting days of care for which Medicare does not pay in the Medicare fraction of the Medicare DSH percentage – a policy change widely viewed as disadvantageous to hospitals that care for larger numbers of low-income patients. This means that Medicare exhausted days and days of care provided to Medicare enrollees with another source of third-party coverage [...]

iqtsupport2022-06-29T06:00:21-04:00June 29, 2022|Medicare disproportionate share, Medicare DSH|

Federal Health Policy Update for Monday, June 27

The following is the latest health policy news from the federal government as of 2:15 p.m. on Monday, June 27. Some of the language used below is taken directly from government documents. White House The White House COVID-19 response team has briefed the press about the administration’s latest efforts in the response to COVID-19. Find a transcript of that briefing here and find the slides presented during that briefing here. Supreme Court In a case that challenged a 2005 change in how CMS calculates Medicare disproportionate share (Medicare DSH) payments, the Supreme Court has, in a 5-4 decision, reversed a [...]

iqtsupport2022-06-27T16:37:45-04:00June 27, 2022|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for Thursday, March 10

The following is the latest health policy news from the federal government as of 2:30 p.m. on Thursday, March 10. Some of the language used below is taken directly from government documents. White House The White House has posted a transcript of the March 2 press briefing given by its COVID-19 response team to outline the administration’s National COVID-19 Preparedness Plan. 340B Eligibility Protection and Telehealth Extensions in the Omnibus Spending Bill Providers that feared they might lose their eligibility to continue participating in the 340B prescription drug discount program because they have fallen below that program’s Medicare disproportionate share [...]

iqtsupport2022-03-10T17:37:25-05:00March 10, 2022|Centers for Medicare & Medicaid Services, Congress, Coronavirus, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicare, Medicare disproportionate share, Medicare DSH, Medicare reimbursement policy, MedPAC, Telehealth|

Federal Health Policy Update for Thursday, August 5

The following is the latest health policy news from the federal government as of 2:45 p.m. on Thursday, August 5. Some of the language used below is taken directly from government documents. Final Medicare Inpatient Prospective Payment System Regulation for FY 2022 CMS has published its final Medicare inpatient prospective payment system regulation for FY 2022. Highlights include: An increase in hospital inpatient rates of 2.5 percent and an increase in long-term hospital rates averaging 0.9 percent. The Medicare disproportionate share (Medicare DSH) payments uncompensated care allocation has been cut $1.1 billion, to $7.2 billion, with distribution to be based [...]

iqtsupport2021-08-05T18:29:15-04:00August 5, 2021|Center for Medicare and Medicaid Innovation, CMMI, Coronavirus, COVID-19, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for Friday, July 2

The following is the latest health policy news from the federal government as of 2:45 p.m. on Friday, July 2. Some of the language used below is taken directly from government documents. Supreme Court The Supreme Court has announced that it will hear a case in its next term challenging cuts in 340B payments and another involving Medicare disproportionate share. White House The White House has posted a transcript of the July 1 press briefing given by its COVID-19 response team and public health officials. The transcript includes the announcement that the federal government will be launching surge response teams [...]

iqtsupport2021-07-05T22:53:55-04:00July 5, 2021|340b, Coronavirus, COVID-19, Medicare disproportionate share, Medicare DSH|

Federal Health Policy Update for Thursday, April 29

The following is the latest health policy news from the federal government as of 2:30 p.m. on Thursday, April 29. Some of the language used below is taken directly from government documents. The White House COVID-19 The White House has posted a transcript of the April 27 press briefing provided by its COVID-19 response team and public health officials. Health Policy News Speaking before a joint session of Congress, President Biden on Wednesday night formally presented his proposed American Families Plan. In general, the plan defers action on most health care matters to other, separate legislation, but it does call for [...]

iqtsupport2021-04-29T17:06:18-04:00April 29, 2021|Coronavirus, COVID-19, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare reimbursement policy|

CMS Finalizes FY 2021 Payments to Hospitals

Medicare has announced how it will pay hospitals for inpatient care in FY 2021 with publication of its annual inpatient prospective payment system regulation last week. Among the changes announced by the Centers for Medicare & Medicaid Services: A 2.9 percent increase in fee-for-service inpatient rates. A compromise on its proposal to require hospitals to report their payer-specific negotiated rates with Medicare Advantage plans. Changes in how Medicare will calculate Medicare disproportionate share (Medicare DSH) uncompensated care payments. A much smaller cut than originally proposed in the pool of funds for Medicare DSH uncompensated care payments. Minor adjustments in the [...]

iqtsupport2020-09-09T06:00:15-04:00September 9, 2020|hospitals, Medicaid regulations, Medicare disproportionate share, Medicare DSH, Medicare reimbursement policy|