safety-net hospitals

CMS Sets Soft Launch for 340B Data Repository

The Centers for Medicare & Medicaid Services will launch a new Medicare Part D Claims Data 340B Repository on October 1. The agency’s 340B data repository will be a centralized, federally managed information system that will collect, store, and process specific claim-level utilization data for prescription drugs dispensed under the Medicare Part D benefit that also are subject to discounts through the 340B Drug Pricing Program. CMS developed the repository to support implementation of the Medicare Prescription Drug Inflation Rebate Program, which was mandated by the Inflation Reduction Act of 2022. Under this program, the federal government must exclude drug [...]

joe2026-09-02T12:49:27-04:00September 3, 2026|340b, Medicare|

More Medicaid DSH Money Coming for Some Hospitals?

Some hospitals may be in line for larger Medicaid disproportionate share hospital payments as a result of a federal court decision that calls for changes in how those Medicaid DSH payments are calculated. Last week, a U.S. District court in Texas again vacated a 2023 Centers for Medicare & Medicaid Services regulation that excludes inpatient days covered by uncompensated care pools, such as through section 1115 waivers, when quantifying Medicaid days for the purpose of calculating hospitals’ Medicaid DSH payments. This decision applies nationwide and has implications for the computation of some hospitals’ Medicaid DSH payments and for establishing hospitals’ [...]

joe2026-08-05T11:40:12-04:00August 6, 2026|340b, hospitals, Medicaid disproportionate share, Medicaid DSH|

Erosion of Rural Maternity Care Continues

At a rate of more than two a month since the end of 2020, rural hospitals have closed or announced that they will be closing their maternity units – 124 in all by the end of 2026. As a result, today only a little more than 40 percent of rural hospitals – most of them safety-net hospitals – continue to provide maternity services, with fewer than a third of such rural hospitals doing so in 12 states. The hospitals blame a number of factors for this continued erosion, including inadequate private insurance and Medicaid payments and difficulty recruiting the providers [...]

joe2026-01-27T16:25:01-05:00January 28, 2026|hospitals, Medicaid|

Urban Safety-Net Hospitals Most Vulnerable to Looming Health Care Cuts

While a great deal of attention has been paid to the potential implications for rural hospitals of the coming $1 trillion in federal health care spending cuts over the next decade, it turns out that urban safety-net hospitals, not rural hospitals, may be even more vulnerable to the effects of these cuts. According to an analysis by the New York Times and Harvard’s T.H. Chan School of Public Health, of the 109 hospitals in the country that will be most vulnerable to these cuts, 85 percent are urban safety-net hospitals and not rural hospitals. Three factors drive this vulnerability: their [...]

joe2025-12-04T16:51:55-05:00December 8, 2025|Congress, hospitals, Medicaid|

Federal Health Policy Update for May 30

The following is the latest health policy news from the federal government for May 24-30. Some of the language used below is taken directly from government documents. Congress When the House and Senate return to Washington, DC from the Memorial Day recess next week committees will resume holding hearings and markups on health care policy while appropriators will focus on funding for federal fiscal year 2025, which begins October 1. While there seems to be plenty of activity in Congress it is widely expected that only the most essential bills, like emergency supplemental packages and bills to keep the federal [...]

joe2024-05-30T21:29:22-04:00May 30, 2024|340b, Centers for Medicare & Medicaid Services, Congress, COVID-19, hospitals, Medicaid, Medicaid managed care, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

Proposal Would Establish New “Essential Health System” Designation

The newly proposed “Reinforcing Essential Health Systems for Communities Act” would create a new federal hospital designation that would create a mechanism for directing more federal resources to safety-net hospitals that care for more low-income and uninsured patients. The bipartisan bill, sponsored by Representatives Lori Trahan (D-MA) and David Valadao (R-CA), would, according to Rep. Trahan, … provide federal lawmakers with the avenues necessary to target funding and resources to these critical facilities – just as we’ve done with other types of hospitals that serve specific populations or regions. Hospitals would qualify for “essential health system” status by meeting one [...]

joe2024-02-20T17:02:55-05:00February 20, 2024|Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicare, Medicare reimbursement policy|

MedPAC Meets, Makes 2025 Payment Recommendations

2025 Medicare payments led the agenda at last week’s meeting of the Medicare Payment Advisory Commission. After hearing presentations on the various Medicare payment systems and discussing the adequacy of current Medicare reimbursement, MedPAC’s commissioners provisionally endorses the following changes in 2025 Medicare payments. Inpatient and outpatient services – an update provided for in current law plus 1.5 percent and a shift to a safety-net index policy that would pay safety-net hospitals another $4 billion. Physicians and other health professionals – an increase of 50 percent of the Medicare economic index and introduction of an add-on payment for services provided [...]

joe2023-12-12T17:52:27-05:00December 13, 2023|hospitals, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care|

MACPAC Proposes New Approach to Helping Safety-Net Hospitals

To improve “…the relationship between total state and federal DSH [Medicaid disproportionate share] funding and the number of non-elderly low-income individuals in a state,” the Medicaid and CHIP Payment and Access Commission has urged Congress to direct the Department of Health and Human Services to change how it calculates Medicaid DSH allotments to the states. This year MACPAC devotes a significant portion of its annual report to Congress to payment policy for safety-net hospitals, and in summarizing its proposal it writes that: In order to reduce the wide variation in state disproportionate share hospital (DSH) allotments based on historical spending, [...]

iqtsupport2023-06-26T06:00:13-04:00June 26, 2023|Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments|

Hospitals Seek Delay in Medicaid DSH Cuts

“Delay upcoming cuts in Medicaid DSH payments” is the message hospitals delivered to Congress recently in response to a reduction of $8 billion in Medicaid disproportionate share cuts scheduled to take effect on October 1. The cuts, mandated by the Affordable Care Act, have been delayed by Congress on several occasions over the years in response to the belief that far more people remain uninsured than was anticipated when the 2010 health care reform law was adopted. According to proponents of the delay, the safety-net hospitals that receive Medicaid DSH payments continue to provide free care to significant numbers of [...]

iqtsupport2023-03-09T06:00:35-05:00March 9, 2023|hospitals, Medicaid disproportionate share, Medicaid DSH|

MedPAC Considers 2023 Medicare Rates at December Meeting

The government agency that advises Congress on Medicare payment matters met publicly in Washington, D.C. last week. During the virtual meeting, members of the Medicare Payment Advisory Commission discussed and debated: Assessing payment adequacy and updating payments: hospital inpatient and outpatient services and supporting Medicare safety-net hospitals – commissioners discussed a proposal to increase FY 2024 rates one percentage point more than current law prescribes. Commissioners also discussed additional steps they might take to provide better support to safety-net hospitals, which they described as “…hospitals with high shares of low-income Medicare patients.” Status report: ambulatory surgical center services. Assessing payment [...]

iqtsupport2022-12-14T06:00:43-05:00December 14, 2022|Congress, hospitals, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|