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Advocacy Issue: Presumptive Eligibility
This fact sheet provides hospitals and health systems with an overview of key considerations for implementing presumptive eligibility for charity care. The AHA encourages all members to consider whether some form of presumptive eligibility for charity care makes sense for their organization.
Advocacy Issue: 340B Drug Pricing Program
The 340B program has worked successfully for over 30 years to allow eligible providers to stretch limited federal resources to provide more comprehensive programs and services to more patients. This is exactly what Congress intended when it created the program in 1992.
Advocacy Issue: Site-Neutral Payment Proposals
Hospitals and their associated facilities provide access to critical services that are not otherwise always available in the community and they treat patients with very severe conditions. Payment proposals that attempt to treat hospital outpatient departments the same as independent physician offices and other ambulatory sites of care ignore the very different level of care provided by hospitals and the needs of the patients and communities cared for in that setting.
Advocacy Issue: Rural MDH and LVA Programs
Rural hospitals receive additional support from Medicare to help address potential financial challenges associated with being rural, geographically isolated and low volume. These programs are Medicare-dependent Hospitals (MDHs), Low-volume Adjustment (LVA) and Sole Community Hospitals (SCHs).
Rural Health Services
Over 57 million rural Americans depend on their hospital as an important source of care as well as a critical component of their area's economic and social fabric. Location, size, workforce, payment and access to capital challenge small or rural hospitals and the communities they serve. Collaborating with state and regional hospital associations and with advice from its member council, the Section tracks the issues, develops policies and identifies solutions to our most pressing problems.
Advocacy Issue: Physician-Owned Hospitals
Some members of Congress continue to propose weakening Medicare’s prohibition on physician self-referral to new physician-owned hospitals and loosening restrictions on the growth of grandfathered hospitals. Legislation has been introduced that would allow problematic physician-owned hospitals to open and permit unfettered growth in existing physician-owned hospitals.
Advocacy Issue: Hospital Inpatient (IPPS) Payment
America’s hospitals and health systems continue to face unprecedented financial pressures due to the ongoing effects of the COVID-19 pandemic and current inflationary economy. Historic inflation has extended and heightened the already severe economic instability brought on by the pandemic resulting in razor thin operating margins from massive surges in input costs, including a struggling workforce, drug costs, supplies and equipment.
Advocacy Issue: Long-Term Care Hospital Payment
Long-term care hospitals, or LTCHs, and the other three post-acute care settings have been central to our recovery from COVID-19. The pandemic has particularly highlighted the distinct clinical competencies of LTCHs.
Home Health PPS
The Centers for Medicare & Medicaid Services (CMS) Nov. 1 issued its calendar year (CY) 2025 final rule for the home health (HH) prospective payment system (PPS).