Medicaid disproportionate share

Health Care and the End of the Shutdown

Passage last week of a continuing resolution to fund the federal government brought the 43-day shutdown to an end – and relief for many health care organizations and the people and communities they serve. The final continuing resolution, which extended federal funding through the end of January of next year, includes: Restoring the delay of reductions of Medicaid disproportionate share hospital (Medicaid DSH) payments. Extending authorization for the Medicare Acute Hospital Care at Home program and Medicare telehealth flexibilities. Extending the low-volume hospital adjustment program and the Medicare-dependent hospital program all through that same date. The bill waives the pay-as-you-go [...]

Federal Health Policy Update for November 13

The following is the latest health policy news from the federal government for November 7-13.  Some of the language used below is taken directly from government documents. Please note that during the federal government shutdown, most HHS and other health care-related agencies, with limited exceptions, engaged in little public activity such as announcements, the publication of new regulations, and updating their web sites.  Now that the shutdown has ended, normal activity can be expected to resume shortly. The End of the Federal Government Shutdown On Wednesday night the House passed the Senate-amended version of the continuing resolution (CR) in a [...]

Senate Bill Includes Provisions Vital to Many Hospitals

Last weekend the Senate passed a bill that could, if negotiated successfully with and adopted by the House, temporarily end the current federal government shutdown. Included in the Senate-passed bill are so-called health care extenders that are important to many hospitals, including: A delay in cuts in Medicaid disproportionate share hospital (Medicaid DSH) allotments to the states. A temporary extension of COVID-era telehealth flexibilities. Extension of the Medicare low-volume hospital and Medicare-dependent hospital programs. Extension of authorization for Medicare’s Acute Hospital at Home program. Extension of funding for Community Health Centers and teaching hospitals that operate graduate medical education (GME) [...]

Medicaid DSH Cuts Have (Seemingly) Arrived

Cuts in Medicaid disproportionate share payments, mandated in 2010 under the Affordable Care Act to take effect in 2014 but delayed by Congress ever since, are now scheduled to begin taking effect because Congress’s latest extension of the delay lapsed with the end of the federal fiscal year on September 30. As a result, states – and hospitals that qualify for Medicaid DSH – are expected to see federal Medicaid DSH spending slashed by $8 billion a year for the next three years. Medicaid DSH payments are made to selected hospitals based on how many low-income patients they serve who [...]

Health Care During the Government Shutdown

With the federal government technically without spending authority now that FY 2026 has begun without an approved FY 2026 budget, the federal role in health care will change in some respects and be greatly reduced in others. The Department of Health and Human Services anticipates reducing its workforce by 40 percent during the federal government shutdown while the Centers for Medicare & Medicaid Services anticipates furloughing nearly half its staff.  The Office of Management and Budget has issued a memo encouraging agencies to consider making at least some and possibly many of these furloughs permanent. Medicare and Medicaid will continue [...]

Federal Health Policy Update for September 25

The following is the latest health policy news from the federal government for September 19-25.  Some of the language used below is taken directly from government documents. Federal Funding for Fiscal Year 2026 Telehealth and Acute Hospital Care at Home Program Flexibilities Many current telehealth flexibilities and authorization for the Acute Hospital Care at Home program will expire on September 30 unless Congress extends them.  The following is CMS’s current guidance on these programs if they are not extended by September 30: The CMS Acute Hospital Care at Home web page advises stakeholders that The Acute Hospital Care at Home [...]

Federal Health Policy Update for September 18

The following is the latest health policy news from the federal government for September 12-18.  Some of the language used below is taken directly from government documents. Congress Funding for the federal government expires on September 30.  Members of Congress have not yet coalesced around a plan to fund the federal government when the new federal fiscal year begins on October 1, with House Republican and Democratic leaders releasing competing legislative texts for a short-term continuing resolution (CR). House Republicans have proposed a CR to last through November 21 with very few anomalies, or policy changes, outside of regular spending.  [...]

Federal Health Policy Update for September 11

The following is the latest health policy news from the federal government for September 5-11.  Some of the language used below is taken directly from government documents. Congress With fewer than three weeks until the end of the federal fiscal year, congressional leaders are beginning to devise a strategy to avoid a federal government shutdown on October 1.  Whatever strategy they ultimately adopt will certainly involve some form of continuing resolution (CR).  Some conservatives in Congress would like to see a full-year CR that would keep funding at current levels and permit the President to cut spending via rescissions.  Appropriators [...]

Federal Health Policy Update for September 4

The following is the latest health policy news from the federal government for August 29 – September 4.  Some of the language used below is taken directly from government documents. Congress The House and Senate have returned to Washington D.C., where their focus has turned to funding for the federal government, which expires on September 30.  Senior appropriators predict that Congress will pass a continuing resolution (CR) to keep the government open through at least mid-November.  We expect any CR to include a number of health care extenders for programs that also expire after September 30, including for telehealth flexibilities, [...]

Federal Health Policy Update for August 28

The following is the latest health policy news from the federal government for August 22-28.  Some of the language used below is taken directly from government documents. Congress The House and Senate are in recess and will return to Washington D.C. on September 2.  Funding for the federal government expires on September 30, as will a number of health care extenders, including for telehealth flexibilities, the Acute Hospital Care at Home program, the Medicare-dependent hospital and low-volume hospital programs, and delays to reductions to Medicaid disproportionate share (Medicaid DSH) allotments. Congressional Budget Office (CBO) The CBO has written to congressional [...]

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