AHA dismayed over final rule on Medicaid DSH calculation

Mar 31, 2017 - 03:33 PM

The Centers for Medicare & Medicaid Services March 30 issued a final rule addressing how third-party payments are treated when calculating the hospital-specific limitation on Medicaid disproportionate share hospital payments.

The AHA expressed deep disappointment in the rule. “Of particular concern is the decision by CMS to ignore requests to apply this change in policy in a prospective manner to give states and hospitals sufficient time to make needed adjustments to ensure compliance,” AHA Executive Vice President Tom Nickels said in a March 31 press statement. "We view this action as a good example of the need for significant regulatory reform and urge CMS to reconsider the rule.”

According to CMS, the final rule clarifies current policy that uncompensated care costs for Medicaid-eligible individuals include only those that remain after accounting for payments hospitals receive by or on behalf of Medicaid-eligible individuals, including Medicare and other third-party payments that compensate the hospitals for care furnished to such individuals. The agency issued its original policy in sub-regulatory guidance.

In a comment letter last year on the proposed rule, the AHA called for CMS to withdraw the proposed rule, which it said was “substantive and establishes new policy, specifically with the intent of avoiding potentially unfavorable federal district court rulings agency faced legal challenges.” 

Related News Articles

Headline
HHS clarifies when state Medicaid agencies can use patient SUD records to verify exemption from community engagement requirements
The Department of Health and Human Services Office for Civil Rights released new guidance on statutory and regulatory requirements under 42 CFR Part 2, which…
Headline
CMS launches outcomes-driven quality measurement initiative for states 
The Centers for Medicare & Medicaid Services Sept. 25 announced the launch of a new initiative measuring quality in Medicaid and the Children’s Health…
Headline
AHA recommends changes to CMS’ Medicaid provider tax proposed rule
The AHA commented Sept. 21 on the Centers for Medicare & Medicaid Services’ proposed rule to implement the changes to Medicaid provider tax policies that…
Headline
AHA requests CMS reconsider provisions within Medicaid community engagement rule
The AHA July 31 provided comments to the Centers for Medicare & Medicaid Services on its interim final rule on Medicaid community engagement requirements.…
Headline
CMS issues proposed provider tax rule
The Centers for Medicare & Medicaid Services today released a proposed rule that would update Medicaid provider tax policies included in the July 2025…
Headline
AHA comments to CMS on proposed rule covering Medicaid supplemental payments
The AHA provided comments July 21 to the Centers for Medicare & Medicaid Services on its proposed rule to modify policies governing Medicaid…