National hospital organizations, including the AHA, today urged Congress to include in the short-term continuing resolution under consideration this week a two-year delay in Medicaid disproportionate share hospital cuts, as well as straight extensions of the Medicare-dependent hospital and enhanced low-volume adjustment programs. The Affordable Care Act reduced payments to the Medicaid DSH program under the assumption that uncompensated care costs would decrease as health care coverage increased, and $2 billion in fiscal year 2018 reductions began Oct. 1, 2017. “Unfortunately, the coverage rates envisioned under the ACA have not been fully realized, and tens of millions of Americans remain uninsured,” the groups wrote. In addition, the groups urged Congress to extend, which it has done many times, the MDH and LVA programs. “The MDH program adjusts payments to hospitals for which Medicare patients make up a significant percentage of inpatient days or discharges; the LVA provides an add-on payment to qualifying hospitals to help level the playing field for low-volume providers, and sustain and improve access to care in rural areas,” the groups wrote.

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