The CMS on Monday published a final rule for calculating $4 billion in state Medicaid disproportionate-share hospital cuts for fiscal 2020 and $8 billion for each subsequent year through 2025.
The DSH cuts were supposed to go into effect Oct. 1, but the House of Representatives on Thursday passed a continuing resolution to fund the government and within that was a provision to delay the cuts until Nov. 21. The Senate will likely consider the same bill this week.
The final method considers the rate of uninsured in each state, the number of Medicaid inpatients, the level of uncompensated care in the state and other budget-neutrality factors.
It also clarifies the definition of total hospital cost and specifies state data submission requirements. Lastly, it adjusts the weighting of certain factors required in the methodology by the Affordable Care Act.
The current DSH formula, which skews funding significantly for certain states over others, hasn't changed since 1992. Hospital groups agreed to cuts to the program under the Affordable Care Act as one of the trade-offs for policies like Medicaid expansion, but have successfully secured delays ever since.
But last year, Congress passed the Bipartisan Budget Act that delayed the cuts until fiscal 2020. The final rule goes into effect in 60 days.
