Medicaid Payment and Reimbursement

Limit financial risk from Medicaid redetermination

Medicaid redetermination isn’t going smoothly. As of late December 2023, the Kaiser Family Foundation found that 71% of Medicaid disenrollments nationwide were for procedural reasons. That means patients are losing coverage because they filled out a form incorrectly or missed a deadline, not because they’re truly ineligible for renewal. Provider organizations can play a pivotal…

Noel Felipe January 24, 2024

In Congress, it’s status quo for Medicaid DSH payments and the Medicare physician fee schedule

Yet another short-term federal funding measure from Congress included yet another brief extension of full funding for Medicaid disproportionate share hospital (DSH) payments. With funding for much of the federal government set to expire Jan. 19, Congress agreed on a continuing resolution that keeps all agencies fully operational until March. Medicaid DSH payments are guaranteed…

Nick Hut January 22, 2024

An extended year-end policy update with Nick Hut and Shawn Stack

HFMA Senior Editor Nick Hut and HFMA Policy Director Shawn Stack discuss the most pressing end-of-year issues for 2023.

Erika Grotto December 18, 2023

New data on national healthcare spending highlights the constraints facing hospitals

Recently published 2022 data indicates relatively restrained national healthcare spending as the COVID-19 pandemic faded, especially in the hospital sector. The increase in spending on hospital services slowed from 4.5% in 2021 to 2.2% in 2022, CMS actuaries reported Dec. 13 in Health Affairs. The increase was significantly less than in 2020 (6.2%) and the…

Nick Hut December 18, 2023

House passes bill to codify healthcare price transparency, expand site-neutral payment

The hospital industry saw reason for both relief and disappointment this week after a bill designed to promote price transparency took a major step toward becoming law. The House on Dec. 11 passed H.R. 5378, also known as the Lower Costs, More Transparency Act, by a 320-71 vote. Along with cementing price transparency as the…

Nick Hut December 12, 2023

With a new rule, CMS looks to crack down on states’ Medicaid disenrollment processes

In its latest effort to stem the ongoing wave of Medicaid disenrollments, CMS issued regulations describing its authority to penalize states for disregarding federal guidelines pertaining to the end of continuous-enrollment requirements. Published Dec. 6 in an interim final rule with comment period, the regulations took effect immediately and were based on provisions passed by…

Nick Hut December 11, 2023

Senate bill would give hospitals a big break from looming Medicaid disproportionate share hospital cuts (updated)

Nov. 15 update: On Nov. 14, the House passed legislation on a bipartisan basis to keep the government funded through Jan. 19. Medicaid disproportionate share hospital payments would be guaranteed to remain at their full amount through that date, and the bill similarly maintains short-term funding for graduate medical education, community health centers and the…

Nick Hut November 13, 2023

News Briefs: Medicaid DSH payment cut barely averted in September, still possible in November

Hospitals received a last-day reprieve from substantial cuts to Medicaid disproportionate share hospital (DSH) payments, with House leaders reversing course Sept. 30 and ushering through a six-week government funding package. Language in the bill ensured the start of a four-year Medicaid DSH cut amounting to $32 billion was pushed back from Oct. 1 to Nov.…

Nick Hut October 31, 2023

Medicaid DSH payment cut barely averted as House, Senate pass short-term federal funding

Hospitals received a last-day reprieve from substantial cuts to Medicaid disproportionate share hospital (DSH) payments, with House leaders reversing course Sept. 30 and ushering through a six-week government funding package. Language in the bill ensures a four-year, $32 billion Medicaid DSH cut will not take effect before Nov. 17. Most importantly, the bill bought time…

Nick Hut October 4, 2023

Update: Medicaid DSH payment cut averted as House, Senate pass short-term federal funding

Note: The headline and lead section of this article were updated Oct. 1 with news of a six-week government funding extension that delays the Medicaid DSH cuts and pays for other healthcare programs. The article originally was published Sept. 28 under the headline, “An $8 billion Medicaid DSH cut is closer to happening as a…

Nick Hut October 1, 2023
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