Medicare DSH Archives - Safety-Net Association of Pennsylvania

MedPAC Offers DSH, 340B Recommendations

The Medicare Payment Advisory Commission has recommended that Congress direct changes in the 340B prescription drug discount program and in the manner in which Medicare makes disproportionate share hospital payments (Medicare DSH).
In its annual report to Congress, MedPAC recommended a reduction in 340B prescription drug payments to hospitals. The proposed reduction would cut 340B program spending approximately $300 million.
MedPAC then recommended that those 340B savings be redirected to the Medicare DSH uncompensated care pool.
And it also called for distributing the money in that pool based on better data on the uncompensated care hospitals provide, as reported on hospitals’ Medicare cost report S-10 worksheets, so that the Medicare DSH uncompensated care program would “…better target additional payments to hospitals that provide above average shares of uncompensated care.”
Most Pennsylvania safety-net hospitals participate in both the 340B and Medicaid DSH programs.
To learn more about these and other MedPAC recommendations, see the news release that accompanied the MedPAC report to Congress; a fact sheet on that report; and the report itself.

PA Safety Net Admin2016-03-23T06:00:39+00:00March 23rd, 2016|Medicare|Comments Off

DSH/340B Hospitals Have Lower Medicare Drug Costs

Medicare disproportionate share (Medicare DSH) hospitals that qualify for the federal 340B prescription drug discount program have lower Medicare Part B drug costs than other Medicare providers.
So concludes a new study performed for 340B Health, an association that represents more 1100 public and non-profit hospitals and health systems that participate in the 340B drug pricing program.
According to the organization 340B Health,

Medicare pays disproportionate share hospitals in the 340B drug discount program on average 13 percent less for separately payable drugs reimbursed through Medicare Part B. This is in comparison to what it pays other hospitals and physician practices in the Part B market. The study also shows that 340B DSH hospitals are treating more vulnerable patients than other providers in terms of race, age, disability, and dual eligibility.

The study also found that 340B-eligible hospitals are

Nearly four times as likely as non-340B providers to treat patients with end-stage renal disease
More than twice as likely to treat patients dually eligible for Medicare and Medicaid
More than twice as likely to treat patients who are disabled
More than twice as likely to treat Black, Hispanic, and North American Native patients

All of Pennsylvania’s safety-net hospitals are Medicare DSH hospitals and many participate in the 340B prescription drug pricing program as well.
For a closer look at the study and its findings, go here to see a 340B Health news release on the study and go here to see the study Analysis of Separately Billable Part B Drug Use Among 340B DSH Hospitals and Non-340B Providers.

PA Safety Net Admin2016-02-19T06:00:39+00:00February 19th, 2016|Medicare, Pennsylvania safety-net hospitals|Comments Off

Members of Congress Urge Delay in Medicare DSH Cuts

Fifty-eight members of the House of Representatives have written to House leadership asking them to delay the continued implementation of Affordable Care Act-mandated Medicare disproportionate share (Medicare DSH) cuts.
The letter, to House Speaker John Boehner and minority leader Nancy Pelosi, notes that

…hospitals that qualify for Medicare DSH are, by definition, the very providers caring for the greatest numbers of low-income and low-income elderly patients. In recent years, hospitals have incurred $270 billion in Medicare cuts, including reductions in their annual cost-of-living adjustments, penalties through Medicare’s value-based purchasing and readmissions reduction programs, reduced Medicare bad debt reimbursement, and continued cuts from sequestration. Medicare DSH cuts at this time could jeopardize the health care safety net that our constituents and yours need and deserve.

Medicare DSH payments are vital to most of Pennsylvania’s private safety-net hospitals.
Read the entire congressional letter here.

PA Safety Net Admin2014-06-05T06:00:07+00:00June 5th, 2014|Affordable Care Act|Comments Off

Study Points to Risk of DSH Cuts

A new study suggests that future cuts in Medicare disproportionate share (Medicare DSH) and Medicaid DSH payments could pose problems for hospitals that serve large numbers of uninsured patients.
According to a new report in the journal Health Affairs,

Such cuts in government funding of uncompensated care could pose challenges to some providers, particularly in states that have not adopted the Medicaid expansion or where implementation of health care reform is proceeding slowly.

Medicare DSH and Medicaid DSH payments help underwrite the uncompensated care hospitals provide to their uninsured patients. These payments are a vital source of revenue for Pennsylvania’s safety-net hospitals and Pennsylvania is among the states that have not yet adopted Medicaid expansion.
Even after Affordable Care Act reforms take effect, 25 to 30 million Americans are expected to remain uninsured. Medicare DSH payments are expected to decline $22.1 billion between now and 2019 and Medicaid DSH payments, temporarily delayed by two separate actions of Congress, are expected to decline $17.1 billion through 2020.
Learn more about the Health Affairs study in this Washington Post article and find the study itself here, on the web site of Health Affairs.

PA Safety Net Admin2014-05-07T06:00:01+00:00May 7th, 2014|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off

DSH Delay Bill Picks Up Co-Sponsors

A bill that would delay implementation of Medicaid disproportionate share (Medicaid DSH) and Medicare DSH payment cuts for two years now has 46 co-sponsors in the U.S. House of Representatives.
H.R. 1920, the DSH Reduction Relief Act of 2103, would delay for two years the DSH cuts mandated by the Affordable Care Act.
The rationale underlying the proposal is that between some states choosing not to expand their Medicaid programs as the reform law envisioned and the delay in imposing the mandate for businesses to help their employees with health insurance, the expected rise in the rate of insurance will be slower than expected and hospitals that care for especially large numbers of low-income patients will have a greater need for DSH revenue than originally anticipated.
Because they serve so many more low-income patients than the typical acute-care hospital and Pennsylvania is not among the states planning to expand eligibility for Medicaid, the state’s safety-net hospitals are especially interested in this issue and have conveyed their support for the bill both to Congress and to the administration.
Read more about the proposed DSH delay bill and its prospects for passage in this CQ HealthBeat article presented by the Commonwealth Fund.

PA Safety Net Admin2013-07-19T06:00:20+00:00July 19th, 2013|Health care reform|Comments Off

SNAP Asks PA Delegation to Back DSH Delay

SNAP has asked Pennsylvania’s congressional delegation in Washington to support a bill before the House that would delay planned cuts in Medicare disproportionate share hospital payments (Medicare DSH) and Medicaid DSH for two years.
H.R. 1920, the DSH Reduction Relief Act of 2013, would delay cuts mandated by the Affordable Care Act.
SNAP’s letter to the delegation notes that

These DSH cuts are scheduled to begin…before the Affordable Care Act’s Medicaid and insurance expansion provisions can even begin to have an effect; as you know, moreover, there currently is no plan to expand Medicaid eligibility in Pennsylvania. In addition, the administration recently announced a one-year delay in the reform law’s employer health insurance mandate. Together, Medicare DSH and Medicaid DSH cuts will amount to millions of dollars worth of reductions in payments that safety-net hospitals like ours need to serve their communities, and they would be coming at a time of great ambiguity as implementation of this aspect of the Affordable Care Act gets under way.

Read SNAP’s letter to the PA congressional delegation here .

PA Safety Net Admin2013-07-15T06:00:17+00:00July 15th, 2013|Health care reform|Comments Off

Congressman Calls for Delay on DSH Cuts

Cuts in Medicare DSH and Medicaid DSH payments, scheduled to be take effect beginning in FY 2014, would be delayed for two years under a new bill proposed in Congress.
Under the DSH Reduction Relief Act of 2013, Affordable Care Act-mandated cuts in Medicare disproportionate share payments (Medicare DSH) and Medicaid disproportionate share payments (Medicaid DSH) would not begin until FY 2016, instead of in FY 2014, as the reform law requires.
The bill was proposed by Representative John Lewis (D-GA).
Read more about The DSH Reduction Relief Act in this article from Becker’s Hospital Review.

PA Safety Net Admin2013-05-13T09:36:10+00:00May 13th, 2013|Health care reform|Comments Off

DSH Losses Will Hurt Safety-Net Hospitals

Safety-net and other hospitals will suffer financially when Affordable Care Act-mandated cuts in Medicare disproportionate share hospital payments (Medicare DSH) and Medicaid DSH payments begin taking effect in FY 2014.
So concludes Moody’s, the bond-rating agency.
The losses will be especially harmful to hospitals in states that do not expand their Medicaid programs and to safety-net hospitals, Moody’s believes.
Currently, Pennsylvania has no plans to expand its Medicaid program as envisioned by the Affordable Care Act.
Hospitals face other specific challenges as well as a result of these cuts.
Read more about Moody’s assessment of the impact of future Medicare DSH and Medicaid DSH cuts in this report in Becker’s Hospital Review.

PA Safety Net Admin2013-03-20T06:00:57+00:00March 20th, 2013|Health care reform|Comments Off

Medicare DSH Cuts Loom for PA Safety-Net Hospitals

Safety-net hospitals across the country will soon lose important funding that helps them care for many of their low-income and uninsured patients: their Medicare disproportionate share hospital payments (Medicare DSH).
Come 2014, the Affordable Care Act mandates a significant cut in hospitals’ Medicare DSH payments. The underlying rationale for this cut is that once the health care reform law’s individual insurance mandate takes effect and states begin greatly expanding Medicaid eligibility (a reform law mandate made optional by this year’s Supreme Court decision), hospitals will have fewer such patients and less need for supplemental DSH funding.
But as a Kaiser Health News article points out, hospital officials are concerned that the funding will phase out before the expanded insurance phases in, leaving them with fewer resources to care for their low-income, still-uninsured patients.
Pennsylvania’s safety-net hospitals, which care for large numbers of low-income and uninsured patients, figure to suffer considerably under such circumstances.
Learn more about the phase-down of Medicare DSH payments and the challenges hospitals will face in its wake in this Kaiser Health News article .

PA Safety Net Admin2012-10-17T06:00:13+00:00October 17th, 2012|Health care reform|Comments Off

DSH and the Affordable Care Act

The National Health Law Program has prepared a useful Q&A about how the Affordable Care Act and its Medicaid expansion will affect Medicare disproportionate share (Medicare DSH) and Medicaid disproportionate share (Medicaid DSH) payments, both of which are so important to Pennsylvania’s safety-net hospitals.

Download that summary here .

PA Safety Net Admin2012-07-19T06:00:21+00:00July 19th, 2012|Health care reform, Medicaid supplemental payments|Comments Off

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