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
The Congressional Budget Office today released its estimate of the budgetary effects of the One Big Beautiful Bill Act, as enacted. CBO projects the law will…
Headline
The Centers for Medicare & Medicaid Services July 17 issued two letters to states regarding policies on continuous eligibility and workforce initiatives.…
Headline
Sen. Josh Hawley, R-Mo., July 15 introduced legislation that would repeal some of the Medicaid funding reductions included in the recently enacted One Big…
Headline
The House July 3 voted 218-214 to pass the final version of the One Big Beautiful Bill Act (H.R. 1), which enacts many of President Trump’s legislative…
Headline
The Senate narrowly passed the One Big Beautiful Bill Act (H.R. 1) on July 1 by a 50-50 tally, with Vice President J.D. Vance casting the tie-breaking vote.…
Headline
The AHA June 29 sent a letter to senators urging them to amend the budget reconciliation bill before its final passage in the Senate. The Senate version of the…