CMS Won't Break the DSH Formula Despite Provider Complaints

August 4, 2015

Modern Healthcare (Dickson, 8/4) reported that in the final Inpatient Prospective Payment rule released recently, the Centers for Medicare and Medicaid Services (CMS) said it will distribute an estimated $6.4 billion in uncompensated care payments in fiscal year 2016, a decrease of $1.2 billion from the estimated fiscal year 2015 amount. When it comes to determining what hospitals will receive for their share of Medicare disproportionate-share hospital (DSH) payments, CMS counts a hospital's share of total inpatient days attributable to either a Medicare patient receiving Supplemental Security Income or Medicaid. Some providers say the DSH payments are unfair and politically based. “We recognize it would be possible for hospitals in states that choose to expand Medicaid to receive higher uncompensated care payments because they may have more Medicaid patient days than hospitals in a state that does not choose to expand Medicaid,” CMS said in the final rule.