Appeals Court Reinstates Changes to Medicaid DSH Payments Formula
Hospitals that treat a large proportion of low-income and uninsured patients could face lower Medicaid disproportionate share hospital (DSH) payments following a recent appeals court decision. Earlier...Medicaid DSH Payments Cover 51% of Uncompensated Care Costs
Medicaid Disproportionate Share Hospital (DSH) payments covered about half of the uncompensated care costs incurred by qualifying hospitals nationwide in 2014, according to a Government Accountability...13 States Still Struggle to Check Providers to Avoid Medicaid Fraud
States are struggling to implement effective provider enrollment screening processes to prevent Medicaid fraud, including fingerprint-based criminal background checks, according to a recent HHS Office...5 States Challenge Medicaid Payment Diversion Rule in Court
California Attorney General Xavier Becerra is leading a multi-state effort to upend a new final rule from CMS that bars states from diverting Medicaid payments to third parties on behalf of providers,...CMS Bans Diverting of Medicaid Payments to Home Health Unions
A new final rule from CMS prohibits states from paying a portion of Medicaid payments for providers to third parties, including unions for home health workers. Released May 2, the Medicaid Provider...Medicaid Expansion Improved Financial Stability for Health Centers
Federally qualified health centers in Medicaid expansion states were significantly more likely to report financial stability and funding improvements since the implementation of the Affordable Care Act...Documentation Issues Behind $23B in Medicare Improper Payments
Medicare and Medicaid are on the Government Accountability Office’s (GAO) list of programs that are at an elevated risk for fraud, waste, abuse, and mismanagement after a recent investigation...Hospitals Could Lose Up to $4.1B Under Medicaid Work Requirements
Medicaid work requirements would reduce hospital revenue between $3.7 billion to $4.1 billion in 2019 alone, according to a recent analysis by the Commonwealth Fund. Hospitals in over a dozen states...Slow Down Cuts to Medicaid DSH Payments, MACPAC Tells Congress
The Medicaid and CHIP Payment and Access Commission (MACPAC) recently released its March 2019 report to Congress, which advises policymakers to roll out cuts to Medicaid disproportionate share hospital...Hospital Cost Shifting Still Occurring in CO Despite Coverage Gains
Despite higher Medicaid reimbursement, fewer uninsured individuals, and less uncompensated care costs, hospital cost shifting to commercial payers did not subside in Colorado. Those are the findings...Hospitals Seek Another Delay for $4B Medicaid DSH Payment Cut
America’s Essential Hospitals, American Hospital Association (AHA), Association of American Medical Colleges (AAMC), and five other national hospital groups are calling on policymakers to...Finding Medicaid Eligibility Cuts Hospital Bad Debt by 10%
Extending insurance discovery efforts to insured patients can boost a hospital’s Medicare bad debt recovery by as much as ten percent annually, a new analysis shows. Identifying insured patients...Medicare, Medicaid Reimbursement $76.8B Under Hospital Costs
The largest public payers continue to underpay hospitals, data from the most recent American Hospital Association (AHA) Annual Survey of Hospitals revealed. Medicare and Medicaid reimbursement fell...Sponsored by TransUnion