The Centers for Medicare & Medicaid Services in a Dec. 10 letter to state Medicaid directors provided state agencies with guidance pertaining to two provisions of the Consolidated Appropriations Act of 2021. Section 202 of the CAA specified new state reporting requirements for non-disproportionate share hospital supplemental payments. Section 203 addressed the method for calculating the hospital-specific Medicaid DSH limits. Both provisions have statutory effective dates of Oct. 1, 2021. The guidance outlines CMS’ plans to implement these new requirements while acknowledging this guidance is not complete. The agency notes that additional regulatory guidance will be needed, including further rulemaking for the Medicaid DSH hospital-specific limits provision. 

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