Medicaid supplemental payments Archives - Page 4 of 8 - Safety-Net Association of Pennsylvania

SNAP Thanks PA Delegation for Supporting Short-Term Medicaid DSH Cut Delay

SNAP has written to members of Pennsylvania’s congressional delegation to thank them for voting for a temporary delay of Medicaid disproportionate share (Medicaid DSH) cuts mandated by the Affordable Care Act.

The Medicaid DSH delay was included in a continuing resolution that Congress passed to fund the federal government temporarily while legislators continue to negotiate an FY 2020 federal budget. The continuing resolution and the Medicaid DSH cut delay run through November 21.

Medicaid DSH cuts mandated by the Affordable Care Act have already been delayed several times by Congress, but if not delayed again, Pennsylvania will see its federal Medicaid DSH allotment fall 40 percent in FY 2020 and 80 percent a year from FY 2021 through FY 2025.

See SNAP’s thank you note to Pennsylvania’s congressional delegation here.

PA Safety Net Admin2019-10-03T06:00:35+00:00October 3rd, 2019|DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

CMS Adopts Methodology for Medicaid DSH Cuts

Medicaid DSH money will be allocated among states based on a new methodology under a regulation adopted this week by the Centers for Medicare & Medicaid Services.

But it is not clear when that new methodology may actually be used.

Cuts in Medicaid disproportionate share hospital (Medicaid DSH) allotments to states were mandated by the Affordable Care Act based on the expectation that the law would greatly reduced the number of uninsured Americans. While this has been the case, the decline in the number of uninsured has not been as great as expected. For this reason, Congress has on several occasions delayed the required Medicaid DSH cut.

That cut is now scheduled to take effect next week, on October 1, but a continuing resolution to fund the federal government, passed last week by the House and now under consideration by the Senate, would delay that cut again – at least until November 22.

Should the cut be implemented, Pennsylvania would lose 40 percent of its Medicaid DSH allotment from the federal government in FY alone and that cut would rise to 80 percent a year from FY 2021 through FY 2025. Pennsylvania safety-net hospitals view Medicaid DSH as an important part of their effort to care for the uninsured and underinsured residents of the low-income communities in which they are located.

Learn more about the new regulation governing the future allotments of Medicaid DSH money to the states and the prospects for Medicaid DSH allocation cuts being made anytime soon in the Healthcare Dive article “CMS finalizes Medicaid DSH cuts, but Congress could still delay” and see the regulation itself here.

PA Safety Net Admin2019-09-25T10:59:52+00:00September 25th, 2019|Affordable Care Act, DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania Medicaid, Pennsylvania safety-net hospitals|Comments Off

SNAP Takes Position on State Medicaid Funding After Hahnemann Closure

Pennsylvania’s Medicaid resources should follow now-closed Hahnemann University Hospital’s Medicaid patients as those patients turn to new providers, the Safety-Net Association of Pennsylvania declared in a position statement issued this week.

Safety-Net Association of Pennsylvania logo According to SNAP,

…the best way to protect access to care and prevent additional financial strain on Philadelphia hospitals is to ensure that all state resources reallocated in the wake of Hahnemann University Hospital’s closure follow the displaced patients.

In preparation for addressing this challenge, SNAP performed a data-based analysis of where Medicaid patients turned for care upon the closing of St. Joseph’s Hospital, like Hahnemann a high-volume Medicaid provider and located in the same community as Hahnemann, in 2016. This analysis identified where patients went when St. Joseph’s closed and in its position statement, SNAP urges state policy-makers to perform similar analyses and ensure that state Medicaid resources, especially supplemental payments made to hospitals that serve especially large numbers of Medicaid patients, be distributed to the hospitals that actually serve displaced Hahnemann patients. Such an approach, SNAP maintains, is the best way to ensure the future of the health care safety net in Philadelphia.

Learn more in the SNAP position statement “Protecting Philadelphia’s Health Care Safety Net From the Financial Implications of the Closing of Hahnemann University Hospital.”

PA Safety Net Admin2019-09-18T13:24:14+00:00September 18th, 2019|Medicaid supplemental payments, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

Medicaid DSH Delay Advances in Energy and Commerce Committee

Medicaid disproportionate share cuts would be delayed for two years under a proposal advanced last week by the Health Subcommittee of the House Energy and Commerce Committee.

The Medicaid DSH cuts, mandated by the Affordable Care Act, have already been delayed three times by Congress and could be on their way to a fourth delay if the proposal advanced by the Health Subcommittee is endorsed by the Energy and Commerce Committee and works its way to the full House of Representatives, where such a proposal is thought to enjoy wide support.

The Safety-Net Association of Pennsylvania supports this delay of Medicaid DSH cuts. Earlier this year, SNAP asked members of the state’s congressional delegation to join a campaign in the House of Representatives to delay this cut.

Learn more about the possibility of another delay of Medicaid DSH cuts in the HealthLeaders article “House Panel Advances Surprise Bill Package.”

PA Safety Net Admin2019-07-16T06:00:31+00:00July 16th, 2019|DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments|Comments Off

Medicaid DSH Delay Wins Bipartisan Support

More than 300 members of the U.S. House have joined a letter to House leadership urging a delay in Affordable Care Act-mandated cuts in Medicaid disproportionate share payments (Medicaid DSH).

The bipartisan letter notes that hospitals that receive Medicaid DSH funds cannot absorb the loss of revenue such a cut would bring. That cut, scheduled to begin in FY 2020, would amount to a $4 billion reduction in nation-wide Medicaid DSH spending in FY 2020 and an $8 billion reduction in each of FY 2021, FY 2022, FY 2023, FY 2024, and FY 2025.

SNAP was actively involved in urging Pennsylvania House members to join the letter. If implemented, the Medicaid DSH cuts would be especially harmful to SNAP members and all Pennsylvania safety-net hospitals – and to the low-income residents of the communities they serve.

See the bipartisan letter seeking a delay of Medicaid DSH cuts here.

PA Safety Net Admin2019-05-24T06:00:46+00:00May 24th, 2019|Affordable Care Act, DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments|Comments Off

SNAP Joins Letter Urging Preservation of Tobacco Funding

The Safety-Net Association of Pennsylvania has joined 10 other organizations in urging Pennsylvania’s General Assembly to use 100 percent of Tobacco Settlement Fund monies for health-related services and programs in the coming fiscal year.

Safety-Net Association of Pennsylvania logo For FY 2018-2019, Pennsylvania borrowed against future proceeds from the Tobacco Settlement Fund to help balance the state budget. Debt service payments will soon be due and the Wolf administration has proposed paying that debt service with proceeds from the state’s sales and use taxes. In a letter to state legislators, SNAP and the others endorse this aspect of the administration’s proposed budget FY 2019-2020 budget.

Tobacco fund proceeds are vital to Pennsylvania’s safety-net hospitals, helping to compensate them for some of the care they provide to uninsured and underinsured residents of the communities they serve. Funds used in this manner, moreover, are matched by the federal government, doubling their impact on communities in need.

See the letter here.

PA Safety Net Admin2019-05-16T06:00:26+00:00May 16th, 2019|Medicaid supplemental payments, Pennsylvania proposed FY 2020 budget, Pennsylvania safety-net hospitals|Comments Off

Senate Finance Committee Reports on Supplemental Medicaid Payments

The majority members of the Senate Finance Committee have published a report on supplemental Medicaid payments.

According to the new document,

This report seeks to increase educational understanding of Medicaid supplemental payments, as well as outline the reporting mechanisms for these payments to ensure adequate stewardship of taxpayer dollars.

The report consists of descriptions of the different types of supplemental Medicaid payments that states make to some providers, including:

Medicaid disproportionate share payments (Medicaid DSH)
non-DSH payments
upper-payment limit payments (UPL payments)
demonstration supplemental payments
medical education payments

It also describes the magnitude of these payments, noting that supplemental Medicaid payments accounted for $50 billion of the $600 billion spent on Medicaid by the federal and state governments in 2016, the most recent year for which comprehensive data is available. In addition, it outlines how those payments are distributed while also considering how these payments affect the overall adequacy of Medicaid payments to providers; this varies from state to state.

Finally, the report reviews how the states finance their Medicaid programs, including through provider taxes, intergovernmental transfers, and certified public expenditures, and how states report their supplemental Medicaid payments to the federal government.

All Pennsylvania safety-net hospitals receive supplemental payments from the state and consider those payments essential resources supporting their ability to serve the residents of the low-income communities in which they are generally located.

To learn more, see the report “Greater Transparency of Supplemental Payments Needed,” which was prepared by the majority staff of the Senate Finance Committee.

PA Safety Net Admin2019-05-06T06:00:12+00:00May 6th, 2019|DSH hospitals, Medicaid supplemental payments, Pennsylvania safety-net hospitals|Comments Off

SNAP Asks Congress for Help on Medicaid DSH

Prevent Medicaid DSH cuts: that is the message the Safety-Net Association of Pennsylvania conveyed to Pennsylvania’s congressional delegation this week.

In a message sent to every member of the U.S. House of Representatives from Pennsylvania, SNAP asked members to sign onto a letter to House Speaker Nancy Pelosi asking her to delay Affordable Care Act-mandated cuts in Medicaid disproportionate share payments (Medicaid DSH) that are scheduled to take effect in October of this year.

If implemented, the cut would hurt 179 of Pennsylvania’s 213 hospitals, including all safety-net hospitals, and cost the state approximately $240 million in Medicaid DSH revenue in FY 2020 and $480 million a year in FYs 2021 through 2025.

See the letter requesting action on Medicaid DSH cuts here and SNAP’s message to Pennsylvania’s congressional delegation here.

PA Safety Net Admin2019-04-24T14:49:48+00:00April 24th, 2019|Affordable Care Act, DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

MACPAC Recommends Changes in Medicaid Shortfall Definition

Hospitals’ calculation of their Medicaid shortfall would change under a recommendation that MACPAC voted to make to Congress. That change, in turn, could affect hospitals’ future Medicaid disproportionate share payments.

Last week the Medicaid and CHIP Payment and Access Commission voted overwhelmingly to change how hospitals calculate their Medicaid shortfall: the difference between what they spend caring for their Medicaid patients and what Medicaid pays them for that care. Under MACPAC’s proposal, hospitals would need to deduct from their shortfall total all third-party payments they receive for the care they provide to their Medicaid patients.

If this proposal were to be adopted, it has the potential of changing Medicaid DSH allocations among the states and change the distribution of Medicaid DSH funds within individual states, although the Congressional Budget Office estimates that it would have little impact on either measure.

Complicating the MACPAC recommendation is last year’s federal court ruling that third-party payments could not be deducted from hospitals’ Medicaid shortfall totals because the Centers for Medicare & Medicaid Services lacks the authority to implement such a policy. Making such a change therefore would require action by Congress.

Learn more about the MACPAC recommendation and its potential implications for hospitals and their Medicaid DSH payments in the Fierce Healthcare article “’Medicaid shortfall’ definition should change when tallying DSH payments, MACPAC says.”

PA Safety Net Admin2019-04-19T06:00:38+00:00April 19th, 2019|DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments|Comments Off

SNAP Endorses Governor’s Proposal for Paying for Tobacco Borrowing

Debt service on the state’s borrowing against future proceeds from the national master tobacco settlement agreement should be paid using state sales and use tax revenue, SNAP has declared in a new position statement.

Last year the state borrowed $1.5 billion against future proceeds from the tobacco settlement. Some tobacco settlement money is used to help hospitals with the cost of uncompensated care they provide via tobacco uncompensated care payments and tobacco extraordinary expense payments made to hospitals that meet specific criteria: how much uncompensated care they provide, the proportion of their patients insured by Medicaid, and the proportion of low-income seniors they serve. All Pennsylvania safety-net hospitals qualify for these payments.

Safety-Net Association of Pennsylvania logo Because the state’s borrowing against future tobacco settlement proceeds was never intended to result in a reduction of these payments in the future, SNAP has issued a position statement endorsing the Wolf administration’s suggestion, in its proposed FY 2020 budget, to pay debt service on its tobacco borrowing with sales and use tax revenue.

PA Safety Net Admin2019-04-16T06:00:51+00:00April 16th, 2019|Medicaid supplemental payments, Pennsylvania Medicaid policy, Pennsylvania proposed FY 2020 budget, Pennsylvania safety-net hospitals, Pennsylvania state budget issues|Comments Off

SNAPShots

SNAPShots

Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us

Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us