Medicare disproportionate share payments

Supreme Court Rejects Medicare DSH Challenge

The Supreme Court has rejected the appeal of a lower court ruling that found that the Centers for Medicare & Medicaid Services did not undercalculate hospitals’ Medicare disproportionate share payments between 2006 and 2009. In the suit, more than 200 hospitals argued that the calculation of Medicare DSH payments should be based on all hospitalized patients who qualify for both Supplemental Security Income (SSI) and Medicare. The Supreme Court disagreed, confirming in a 7-2 decision the ruling of lower courts that SSI should only be included in DSH calculations when Medicare patients receive SSI payments during the same month they [...]

joe2025-05-01T16:43:24-04:00May 5, 2025|Medicare disproportionate share, Medicare DSH|

Federal Health Policy Update for May 1

The following is the latest health policy news from the federal government for April 25 – May 1. Some of the language used below is taken directly from government documents. Congress Reconciliation The House and Senate returned to Washington D.C. this week and House committees have begun marking up reconciliation legislation for submission to the House Budget Committee by May 9. The Energy and Commerce Committee is expected to seek nearly $550 billion in cuts to Medicaid spending and the most likely targets for cuts continue to be work requirements for Medicaid eligibility; more frequent review of Medicaid eligibility; reducing the federal [...]

joe2025-05-01T15:33:24-04:00May 1, 2025|Centers for Medicare & Medicaid Services, Congress, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for January 16

The following is the latest health policy news from the federal government for January 11-17. Some of the language used below is taken directly from government documents. Congress House Budget Committee Republican members of the House Budget Committee have circulated a list of possible policy changes that would reduce federal spending by between $5.3 trillion and $5.7 trillion over a period of ten years. Up to $3.4 trillion of those possible cuts could include reductions in federal health care spending. The health care cuts the document lists (all figures are ten-year reductions) are: Medicare introducing Medicare site-neutral outpatient payments - [...]

Looking Ahead to Lame Duck

When the dust clears after next week’s presidential election, Congress will return to Washington with numerous unfinished matters on its agenda – including many with implications for health care organizations. They include: Federal government funding, authorization for which expires on December 20. Medicare payments to physicians, which many in Congress want to increase if, as proposed, the Centers for Medicare & Medicaid Services reduces those payments for 2025. A potential temporary extension of the continued use of telehealth to prescribe Schedule 2 drugs such as Adderall. Payment adjustments for low-volume and Medicare-dependent hospitals. Renewal of authorization for the COVID-era Acute [...]

joe2024-10-30T17:22:55-04:00October 31, 2024|COVID-19, hospitals, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare cuts, Medicare regulations, Medicare reimbursement policy, Telehealth|

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|