CMS Provides Guidance on Medicaid DSH Calculations
State Medicaid program accounting for hospital uncompensated care when calculating hospital-specific Medicaid disproportionate share limits is the subject of new guidance from the Centers for Medicare & Medicaid Services.
In the guidance, the Centers for Medicare & Medicaid Services explains that because of several court rulings, states can decide for themselves whether to offset third-party payer payments from costs in their Medicaid DSH calculations for periods prior to June 2, 2017 but that beginning with that date, CMS will enforce its own interpretation of the policy.
In new guidance, CMS presents two methodologies for accounting for its mid-year policy change and reminds stakeholders about its new methodology for calculations after June 2, 2017. Pennsylvania’s Department of Human Services and its Office of Medical Assistance Programs have not yet indicated how they will respond to the options CMS has presented.
Learn more from this Medicaid notice and from its accompanying CMS informational bulletin “Treatment of Third Party Payers (TPP) in Calculating Uncompensated Care Costs (UCC).”
Included in this month’s edition are articles about:
Governor Wolf
The Department of Human Services (DHS) has published a reminder that 
During her daily briefing today, Secretary Levine reported that the number of new COVID-19 cases in Pennsylvania yesterday declined slightly from the day before, although she dismissed this decline as “not statistically significant.” There are now COVID-19 cases in 50 of Pennsylvania’s 67 counties. While the number of hospitalizations, ICU cases, and patients put on ventilators remain low, she said those numbers remain in line with trends elsewhere in the country and her department’s own projections.
The Department of Health and Human Services has provided guidance to states asking them to take immediate action to 
The FDA established 
The Department of Drug and Alcohol Programs (DDAP) has issued a document clarifying the state’s response to federal guidance on the disclosure of patients’ substance abuse disorder records during the telehealth process. See that policy clarification 
Since yesterday, the Department of Human Services has issued the following four new guidance documents:
Federal 
The following summary of PA legislative actions was compiled by Cynthia Fernandez of Spotlight PA and Gillian McGoldrick of Lancaster Online.
CMS Catastrophic Plan Coverage Guidance 
United Healthcare, with 57,000 Medicaid members in the city, has placed six homeless members with multiple health problems into apartments in the city – it plans to add four more – and is spending between $1200 and $1800 a month on rent and wrapround services. Its theory: with one percent of the population accounting for 22 percent of annual health care spending nation-wide, helping some of that one percent could improve lives while saving a great deal of money.
Block grants, through what has been named the Healthy Adult Opportunity program, also pose a threat, with Fitch explaining that