Medicaid supplemental payments Archives - Page 6 of 8 - Safety-Net Association of Pennsylvania

MACPAC Looks at Medicaid DSH

With Medicaid disproportionate share payments (Medicaid DSH) facing future reductions, the agency charged with advising Congress on Medicaid and Children’s Health Insurance payment and access matters is considering what changes the federal supplemental Medicaid payment program might need.
At a recent meeting in Washington, D.C., the Medicaid and CHIP Payment and Access Commission discussed the changing role and purpose of Medicaid DSH as more Americans obtain health insurance through private or public sources. MACPAC commissioners noted that hospital uncompensated care is falling, especially in states that have taken advantage of the Affordable Care Act to expand their Medicaid programs.
A new Medicaid DSH formula set to be used for FY 2018, based more heavily than the current formula on the number of uninsured people in individual states, is expected to result in larger-than-average reductions for hospitals in Medicaid expansion states.
Among the steps commissioners discussed were examining how hospitals use their Medicaid DSH funds; considering how any changes in the distribution of Medicaid DSH funds might affect other parts of states’ health care systems; and the role states should play in determining the allocation of Medicaid DSH funds.
Medicaid DSH funds are a vital source of support to help Pennsylvania safety-net hospitals care for their many uninsured patients.
For a closer look at the issue and MACPAC’s deliberations, see this CQ Roll Call article presented by the Commonwealth Fund.

PA Safety Net Admin2016-09-26T06:00:26+00:00September 26th, 2016|Affordable Care Act, Medicaid supplemental payments, Pennsylvania safety-net hospitals|Comments Off

SNAP Comments on Proposed Medicaid DSH Regulation

The Safety-Net Association of Pennsylvania has written to the Centers for Medicare & Medicaid Services to object to how the agency proposes changing its methodology for calculating eligible hospitals’ Medicaid disproportionate share (Medicaid DSH) payments.
In particular, SNAP opposes the manner in which CMS would treat payments from Medicare and third-party payers made on behalf of Medicaid-eligible individuals.
In SNAP’s view, the letter notes,

…the hospital-specific DSH limit has come to penalize the very hospitals that Medicaid DSH payments were designed to support.

The SNAP letter explains that

What concerns SNAP at this time is CMS’s apparent decision to rationalize and codify in regulations a narrower interpretation of the Medicaid DSH limit than what Congress described in section 1923(g) of the Social Security Act.

Read SNAP’s complete letter here.

PA Safety Net Admin2016-09-15T06:00:48+00:00September 15th, 2016|Medicaid supplemental payments, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

CMS Proposes Medicaid DSH Rule

The Centers for Medicare & Medicaid Services has proposed a new rule that would clarify the basis for eligible hospitals’ Medicaid disproportionate share hospital payments (Medicaid DSH).
Individual hospitals’ Medicaid DSH payments are based on their uncompensated care costs and the rule clarifies that only uncompensated costs for Medicaid patients for whom hospitals receive no other payments, such as from Medicare, state or local governments, or third-party payers, would count toward their hospital-specific Medicaid DSH limit.
See the rule here. Interested parties have until September 15, 2016 to submit formal comments to CMS about its proposal.
Representatives of Pennsylvania safety-net hospitals who would like to know more about how this proposal might affect their hospital can use the “contact us” link on this screen to seek further information.

PA Safety Net Admin2016-08-25T06:00:21+00:00August 25th, 2016|Medicaid supplemental payments, Pennsylvania safety-net hospitals|Comments Off

MACPAC Unhappy With How DSH is Dished

Medicaid disproportionate share hospital payments (Medicaid DSH) are not getting to the hospitals that need them most, according to the independent agency that advises Congress and the administration on Medicaid access, payment, and care delivery issues.
In its March 2016 Report to Congress on Medicaid and CHIP, the Medicaid and CHIP Payment and Access Commission found

…little meaningful relationship between DSH allotments and three aspects of DSH payments that Congress asked us to study: 1) the relationship of state DSH allotments to data relating to changes in the number of uninsured individuals, 2) data relating to the amount and sources of hospitals’ uncompensated care costs, and 3) data identifying hospitals with high levels of uncompensated care that also provide access to essential community services for low-income, uninsured, and vulnerable populations.

MACPAC also observed that

Although early reports suggest that the coverage expansions are improving hospital finances in general, it is not yet clear how hospitals that are particularly reliant on Medicaid DSH payments are being affected.

MACPAC further maintains that

…DSH allotments and payments should be better targeted, consistent with their original statutory intent.

Noting an obstacle to such an undertaking, MACPAC

…recommends that the Secretary [of Health and Human Services] collect and report hospital-specific data on all types of Medicaid payments for all hospitals that receive them. In addition, the Secretary should collect and report data on the sources of non-federal share necessary to determine net Medicaid payment at the provider level.

Finally, MACPAC promises to continue looking into this challenge and exploring possible solutions.

In future reports on DSH payment policy, which MACPAC will include in its annual March reports to Congress, the Commission will continue to monitor the ACA’s effect on hospitals receiving DSH payments. We also plan to explore potential approaches to improving targeting of federal Medicaid DSH funding, including modifying the criteria for DSH payment eligibility, redefining uncompensated care for Medicaid DSH purposes, and rebasing states DSH allotments.

To learn more about what MACPAC had to say about Medicaid DSH and other Medicaid- and CHIP-related issues, go here to see the MACPAC report March 2016 Report to Congress on Medicaid and CHIP.

PA Safety Net Admin2016-03-21T06:00:56+00:00March 21st, 2016|Affordable Care Act, Medicaid supplemental payments|Comments Off

GAO: More Information Needed About Supplemental Medicaid Payments

More data is needed about the supplemental Medicaid payments states make to hospitals and how those payments are financed, according to a new report from the U.S. Government Accountability Office (GAO).
According to the GAO, states are increasingly funding non-disproportionate share (Medicaid DSH) supplemental Medicaid payments to hospitals with funds from local governments and providers that are then matched by the federal government. In some states those supplemental payments, with the help of federal Medicaid matching funds, result in hospitals receiving reimbursement from Medicaid that exceeds the cost of the care they provide to their Medicaid patients.
Pennsylvania’s safety-net hospitals receive a number of such supplemental Medicaid payments.
In response to this concern, the GAO has urged the Centers for Medicare & Medicaid Services (CMS) to collect more and better data about how states finance their Medicaid programs and to do more to ensure that accuracy of that data. For its part, CMS maintains that its current efforts are adequate.
Learn more about this issue from the GAO report Improving Transparency and Accountability of Supplemental Payments and State Financing Methods, which can be found here.

PA Safety Net Admin2015-11-13T06:00:33+00:00November 13th, 2015|Medicaid supplemental payments, Pennsylvania safety-net hospitals|Comments Off

Decision to Restore PA Tobacco Money Upheld

The state’s Commonwealth Court has upheld a lower court decision restoring more than $125 million in tobacco funding that an arbitration panel sought to deny the state.
Under the terms of the Tobacco Master Settlement, states receive annual payments from tobacco companies to compensate them for the costs they incur caring for people sickened by cigarettes and smoking. In 2013, an arbitration panel ruled that the state had failed to fulfill all of the settlement agreement’s terms and reduced Pennsylvania’s proceeds from the agreement. A 2014 appeal of that decision restored much of that funding and the Commonwealth Court upheld that decision.
The tobacco funding is used to support smoking cessation programs, cancer research, and health care services. It is an important source of funding for care for low-income Pennsylvanians for the state’s safety-net hospitals.
Learn more about this issue and the Commonwealth Court’s ruling in this Philadelphia Business Journal article.

PA Safety Net Admin2015-04-17T06:00:12+00:00April 17th, 2015|Medicaid supplemental payments, Pennsylvania safety-net hospitals|Comments Off

PA Recoups Tobacco Money in Court Ruling

A Philadelphia court has restored $120 million of Pennsylvania’s share of the annual proceeds from the master settlement that tobacco manufacturers entered into with state governments in 1998.
Last year, an arbitration panel ruled that Pennsylvania had failed to enforce selected tax collection requirements properly and reduced the state’s share of the settlement proceeds by $180 million. The state appealed the ruling, and last week the court restored $120 million of the $180 million reduction mandated by the arbitration panel.
Pennsylvania uses the proceeds of the tobacco settlement for a number of purposes, including to make Tobacco Uncompensated Care Fund payments to hospitals that serve especially large numbers of uninsured patients and to underwrite clinical, health services, and biomedical research under the state’s Commonwealth Universal Research Enhancement Program (CURE).
Tobacco Uncompensated Care Fund payments are a vital source of support for many Pennsylvania safety-net hospitals.
Learn more about the tobacco funding issue, the court’s ruling, and the implications of that ruling in this Allentown Morning Call article.

PA Safety Net Admin2014-04-15T06:00:29+00:00April 15th, 2014|Medicaid supplemental payments|Comments Off

SNAP Comments on Proposed Medicaid Waiver

The Safety-Net Association of Pennsylvania has submitted extensive comments to the Pennsylvania Department of Public Welfare regarding the state’s application for a section 1115 Medicaid waiver needed to enable the state to expand its Medicaid program through private market insurers.
The highlights of SNAP’s comments include its call for extending retroactive eligibility to those who obtain Medicaid coverage through the private market; easing proposed limits on benefits and penalties for non-payment of premiums; retaining the current supplemental Medicaid payments qualified hospitals receive; and pursuing greater investment in the health care infrastructure of communities with especially high proportions of low-income patients.
See SNAP’s complete written submission here..

PA Safety Net Admin2014-01-14T11:47:11+00:00January 14th, 2014|Health care reform, Healthy PA, Medicaid supplemental payments, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off

DPW Reaches Out to Stakeholders Over Tobacco $ Loss

Pennsylvania Department of Public Welfare Secretary Beverly Mackereth has sent the following message to health care providers and other stakeholders that will be affected by the state’s loss of $180 million in national tobacco settlement money as a result of a recent arbitrary decision.

October 2, 2013

I am reaching out to you, our valued stakeholder, to provide you with information about the potential impact of the recent tobacco master settlement agreement (MSA) decision. Please understand this legal action and the potential next steps are in no way a reflection of the quality of your work or actions as a partner with the Department of Public Welfare (DPW). This decision stems back to circumstances that occurred in 2003.

As you may be aware, the Pennsylvania Attorney General’s office recently notified the Governor’s Budget Office that the state’s annual share of the tobacco MSA will be reduced by an estimated $180 million, or 60 percent of the state’s base tobacco payment, as a result of a decision by an arbitration panel to address claims from 2003.

While this decision has immediate impacts to Pennsylvania’s health and human services programs, the Corbett Administration is committed to maintaining direct services and mandatory healthcare programs. I would like to reassure you that we are working diligently to ensure services will continue without interruption for all Pennsylvanians.

The reduction will occur in the state’s April 2014 MSA payment, which supports spending in the current fiscal year. This has forced the state to freeze discretionary funding from the MSA. As of now the only DPW program affected will be uncompensated care payments to hospitals.

Please be assured, this course of action was not arrived at lightly. Immediate action is necessary in the face of such a dramatic decrease in revenues due to the MSA decision. Moving forward, the Attorney General’s Office is preparing an appeal of the decision.

The attached press release provides additional information regarding this issue. I appreciate your time and understanding as we work together on this issue.

Sincerely,
Beverly Mackereth, Secretary
Department of Public Welfare

The loss of uncompensated care payments will pose a major challenge to the state’s safety-net hospitals, which are the primary providers of care to the uninsured in Pennsylvania and the primary recipients of these funds.
Go here for the press release cited above.

PA Safety Net Admin2013-10-04T06:00:00+00:00October 4th, 2013|Medicaid supplemental payments, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

PA Posts FY 2013 Medicaid DSH Eligibility

The Pennsylvania Department of Public Welfare has published a notice in the Pennsylvania Bulletin listing all hospitals eligible for Medicaid disproportionate share adjustments (Medicaid DSH) during the state’s 2013 fiscal year. See the Pennsylvania Bulletin notice here .

PA Safety Net Admin2013-08-21T11:38:38+00:00August 21st, 2013|Medicaid supplemental payments, Pennsylvania Bulletin|Comments Off

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