MACPAC Looks at Medicaid DSH
Hospitals that serve especially large numbers of Medicaid and low-income patients still need Medicaid disproportionate share hospital payments (Medicaid DSH) to avoid red ink despite the expansion of Medicaid and the increase in the number of uninsured people fostered by the Affordable Care Act.
So concludes the Medicaid and CHIP Payment and Access Commission (MACPAC) the non-partisan legislative branch agency that advises Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on Medicaid and Children’s Health Insurance Program issues.
In its March 2017 report to Congress, MACPAC writes that
In both expansion and non-expansion states, deemed DSH hospitals, which are statutorily required to receive DSH payments because they serve a high share of Medicaid-enrolled and low-income patients, continue to report negative operating margins before DSH payments.
This finding reflects the experience of Pennsylvania safety-net hospitals, most of which consider Medicaid DSH to be absolutely critical to their financial health and continued ability to serve their communities.
Learn more about this evaluation, and other facets of the Medicaid DSH program, in this March 2017 report from MACPAC to Congress. Find a summary of the report here.
The process of determining Medicaid eligibility in Pennsylvania either begins or works its way through the state’s county assistance offices.
Among those steps are ensuring that only providers registered with the state’s Medicaid program can prescribe opioids and fill opioid prescriptions for Medicaid patients; monitoring the opioid-prescribing practices of participating Medicaid providers and taking actions when those practices are inappropriate; introducing new opioid prescribing guidelines; improving access to naloxone to fight opioid overdoses; expanding drug treatment programs; and more.
The Pennsylvania Health Law Project has issued a statement detailing its perspective on the recently proposed American Health Care Act, which would both repeal and replace the Affordable Care Act of 2010.
Among the issues on the agenda of the Medicaid and CHIP Payment and Access Commission were:
The reason: for the second time, companies that lost a public bidding process protested the state’s choices. The first time, the state threw out all the bids and started over again. This time the state says it needs more time to deal with the protests, negotiate new contracts, and get the new contractors up and running.
The Kaiser Family Foundation has just created a new tool that enables users to compare and contrast all of the current repeal and replace proposals: you pick the proposals you want to compare and you select the aspects of those proposals that interest you.