CMS allows states to delay enforcement of Medicaid work requirements until July
In a step that likely will reduce Medicaid coverage losses during the first half of 2027, CMS announced new leeway for states implementing the work requirement. Although the requirement will take effect as scheduled Jan. 1 in 43 states and Washington, D.C., states have the option to institute a hold-harmless period through the first six…
Democrat-led Congressional priorities will affect hospitals
Hospitals face a mixed bag of financially positive and negative policies among the priorities of the incoming Democrat-dominated Congress. Although vote counts continue in some races, Democrats gained large majorities in both the House of Representatives and the Senate in the midterm elections. Common priorities among incoming leaders in both chambers include plans to roll…
Q3 2026 hospital earnings show ACA coverage losses and rising Medicaid risks
Changes to federal coverage and Medicaid financing are manifesting in hospital volumes, payer mix and earnings both currently and in projections, according to Q3 2026 investor calls held recently by hospital companies. The most immediate issue is that coverage losses in the Affordable Care Act (ACA) insurance marketplaces continue to create uncompensated-care pressure. For example,…
Court vacates CMS medical frailty restriction in Medicaid work requirement
In a ruling considered favorable to Medicaid beneficiaries and providers, a federal court sided with plaintiffs’ argument that CMS exceeded its authority in regulations defining the medical frailty exemption to the Medicaid work requirement. An Oct. 29 summary judgment by a Massachusetts federal court vacated regulatory language that would have complicated the task of deciding…
CMS guidance details how states can apply the Medicaid medical frailty exemption
New guidance from CMS explains how states can operationalize the medical frailty exemption to the Medicaid work requirement. Per the guidance, the intent is for states to identify medically frail beneficiaries proactively through claims and other existing data to the degree possible, thereby alleviating the administrative burden and risk of coverage loss facing those beneficiaries.…
Medicaid state-directed payments for hospitals face cuts across 37 states under OBBBA
Hospital state-directed payments (SDPs) in at least 37 states are set to be reduced as part of Medicaid cutbacks in the One Big Beautiful Bill Act (OBBBA), according to a new analysis. Roughly $60 billion in current federal spending on hospital SDPs will come in above the OBBBA’s limits, set at 110% of the Medicare…
FastFinance: Health system OBBBA effects, DSH court ruling
HFMA’s FastFinance newsletter is now a podcast. Host Rich Daly discusses the most current and relevant healthcare news, delivered in an easily digestible format. A seven-state health system has garnered federal rural funding under the 2025 federal healthcare overhaul, even as it prepares for adverse impacts next year. Also, this week’s Weird Number: $1.8 trillion.…
Health system sees early OBBBA benefits, coming challenges
A seven-state health system has garnered federal rural funding under the 2025 federal healthcare overhaul, even as it prepares for adverse impacts next year. Nick Olson, executive vice president, CFO and treasurer of Sanford Health, said the health system has garnered $36 million in Rural Health Transformation Program (RHTP) funding to use as startup capital…
Medicaid provider tax proposed rule could cut payments by $220 billion over 10 years
A proposed rule from CMS implements anticipated changes to the system of provider taxes that help fund supplemental reimbursement in Medicaid. The changes are required under the One Big Beautiful Bill Act (OBBBA, also referred to as the Working Families Tax Cut legislation), with the proposed rule filling in details. The repercussions of the rule…
Hospitals brace for Medicaid cuts, some resort to layoffs
Hospitals and health systems are responding to the OBBBA cuts by reducing staff and increasing revenue, while some are also pursuing mergers and acquisitions to improve efficiency and balance their budgets.