MACPAC recommends Congress amend Medicaid DSH program

The Medicaid and CHIP Payment and Access Commission (MACPAC) today approved four recommendations to Congress that would amend the Medicaid Disproportionate Share Hospital program. Building on their 2021 recommendation to implement a countercyclical financing model within the Medicaid program, MACPAC commissioners recommended that Congress implement a countercyclical financing model for Medicaid DSH allotments, which in their view would ensure that DSH allotment funding is preserved when an economic recession is triggered. They also recommended changes intended to prevent an increase in the federal medical assistance percentage from inadvertently reducing total DSH spending, as well as technical changes not expected to affect state allotments or hospital-specific DSH payments.

In other DSH news, the Centers for Medicare & Medicaid Services yesterday announced states’ final disproportionate share hospital allotments for fiscal years 2020 and 2021, and their preliminary DSH allotments for FY 2022 and 2023. The notice also includes the final FY 2020-2021 and preliminary FY 2022-2023 state limits on aggregate DSH payments to institutions for mental disease and other mental health facilities. The allotments are effective 30 days after the notice’s publication in the April 14 Federal Register.