Commenting today on the Centers for Medicare & Medicaid Services’ proposed rule implementing the Affordable Care Act’s reductions to the state Medicaid Disproportionate Share Hospital allotments, AHA said it continues to advocate for the repeal of the reductions and urged the agency to delay implementing the fiscal year 2018 reduction due to significant concerns with the underlying data. CMS’s proposed rule implementing the reductions modifies the DSH Health Reform Methodology developed in 2013 by incorporating new and updated data sources. CMS has yet to provide technical guidance on the calculations and data sources to be used, none of which are publicly available. “This lack of transparency significantly hampers state governments’ and stakeholders’ ability to assess how the DHRM will affect their state DSH allotment, particularly for FY 2018, the first year of the ACA allotment reductions,” wrote Ashley Thompson, AHA senior vice president for public policy analysis and development.