Oct. 2—A final rule tweaked some details of new cuts to Medicare’s uncompensated care payment program.

The Centers for Medicare & Medicaid Services (CMS) issued an interim final rule Sept. 30 tweaking some of the details of the cuts in Medicare disproportionate share hospital (DSH) payments required by the Affordable Care Act (ACA). The rule slightly modified details of the cuts in payments to hospitals that serve disproportionately large numbers of low-income seniors, as previously set forth in the fiscal year 2014 inpatient prospective payment system final rule issued in August.

Among the changes in Monday’s final rule was a modification of the process through which CMS will issue interim and final payments for hospitals with Medicare cost reporting periods that span multiple federal fiscal years. Such changes were sought by some hospital advocates as necessary to limit budgetary complications for those providers.

Another change included tweaking the data required as part of the uncompensated care payment calculation to ensure that Indian Health Service hospitals are included in certain factors of the calculation.

Overall, the ACA was expected to reduce DSH payments by up to $50 billion over 10 years.  

CMS will accept comments on the interim final rule through Nov. 29.

Publication Date: Wednesday, October 02, 2013