Archive for Federal Medicaid issues

GAO: CMS Should Pay More Attention to States’ Financing of Medicaid

The federal government does not adequately monitor how states finance their Medicaid programs. It also lacks a sufficiently clear understanding of how they pay providers of Medicaid-covered services. These are among the conclusions in a new study on Medicaid financing and payments by the U.S. Government Accountability Office. According to the GAO report, GAO estimated that states’ reliance on provider taxes and local government funds decreased states’ share of net Medicaid payments (total state and federal payments) and effectively increased the federal share of net Medicaid payments by 5 percentage points in state fiscal year 2018.  It also resulted in smaller net payments to some providers after the taxes and local government funds they contribute to their payments are taken … Read More

Posted in Federal Medicaid issues, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals

SNAP Asks PA Delegation for COVID-19 Aid

SNAP has written to Pennsylvania’s congressional delegation to request additional COVID-19 legislation between now and the end of the year to help Pennsylvania safety-net hospitals respond to the health care and financial challenges posed by the pandemic. In its letter, SNAP asked Congress for: additional funding for the Provider Relief Fund for assistance to hospitals; extension of the temporary moratorium on continued implementation of the 2011 Budget Control Act’s Medicare sequestration; and the suspension of any other federal cuts for health care providers, such as the scheduled reduction of Medicaid disproportionate share (Medicaid DSH) allocations to the states. Read SNAP’s message to Congress.  

Posted in Coronavirus, COVID-19, DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania Medicaid, Pennsylvania safety-net hospitals

SNAP Seeks Help From End-of-Year Federal Legislation

Eliminate Medicaid disproportionate share hospital cuts (Medicaid DSH), appropriate additional resources for the Provider Relief Fund, and extend the current suspension of the two percent sequestration of Medicare spending, the Safety-Net Association of Pennsylvania asked members of Pennsylvania’s congressional delegation in a letter SNAP sent earlier this week. The request comes as Congress returns to Washington to take up the funding of the federal government at a time when authorization for spending under a continuing resolution ends on December 11.  In addition to addressing federal funding, Congress also may consider COVID-19 legislation. Learn more from SNAP’s letter to Pennsylvania’s congressional delegation.

Posted in COVID-19, DSH hospitals, Federal Medicaid issues, Safety-Net Association of Pennsylvania


The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C. The following is MACPAC’s own summary of the sessions. The October 2020 MACPAC meeting opened with a panel discussion on restarting Medicaid eligibility redeterminations when the public health emergency ends.  It included Jennifer Wagner, director of Medicaid eligibility and enrollment at the Center on Budget and Policy Priorities; René Mollow, deputy director for health care benefits and eligibility at the California Department of Health Care Services; and Lee Guice, director of policy and operations at the Department for Medicaid Services, Kentucky Cabinet for Health and Family Services. After a break, Commissioners heard a panel discussion with Kevin Prindiville, executive director at Justice in … Read More

Posted in Federal Medicaid issues, Pennsylvania safety-net hospitals

Congress Gives Hospitals Medicaid DSH Relief

Medicaid DSH allocations to states will not be reduced right away thanks to a new continuing resolution to fund the federal government through December 11. The Medicare disproportionate share allocation cuts to the states, mandated by the Affordable Care Act but delayed by Congress several times, were delayed again earlier this year but scheduled to take effect on November 11.  With the latest continuing resolution, the cuts will be delayed yet another month. SNAP worked hard to encourage Congress to include the Medicaid DSH delay in the continuing resolution, doing so most recently in this September 14 letter to members of Pennsylvania’s congressional delegation.  Medicaid DSH payments are an important tool in helping Pennsylvania safety-net hospitals serve their predominantly low-income … Read More

Posted in Federal Medicaid issues, Medicaid supplemental payments

MFAR is Dead

At least for now. The controversial Medicaid Fiscal Accountability Regulation, slated for implementation this fall over the objections of many health care stakeholders, will not move forward at this time. In a tweet earlier this week, Centers for Medicare & Medicaid Services Administrator Seema Verma wrote that We’ve listened closely to concerns that have been raised by our state and provider partners about potential unintended consequences of the proposed rule, which require further study.  Therefore, CMS is withdrawing the rule from the regulatory agenda. If implemented, opponents maintained, the regulation would have: Deprived states of important, established policy-making prerogatives. Created major new administrative burdens for state governments and hospitals. Inappropriately regulated financing of the state share of Medicaid spending. Introduced … Read More

Posted in Federal Medicaid issues, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania

CMS Provides Guidance on Medicaid DSH Calculations

State Medicaid program accounting for hospital uncompensated care when calculating hospital-specific Medicaid disproportionate share limits is the subject of new guidance from the Centers for Medicare & Medicaid Services. In the guidance, the Centers for Medicare & Medicaid Services explains that because of several court rulings, states can decide for themselves whether to offset third-party payer payments from costs in their Medicaid DSH calculations for periods prior to June 2, 2017 but that beginning with that date,  CMS will enforce its own interpretation of the policy. In new guidance, CMS presents two methodologies for accounting for its mid-year policy change and reminds stakeholders about its new methodology for calculations after June 2, 2017. Pennsylvania’s Department of Human Services and its … Read More

Posted in Federal Medicaid issues, Pennsylvania Medicaid, Pennsylvania Medicaid policy

SNAP Asks PA Senators for COVID-19 Help

Pennsylvania’s safety-net hospitals need help with the challenges posed by the COVID-19 public health emergency, SNAP wrote yesterday in a letter to Pennsylvania senators Pat Toomey and Bob Casey. In its letter, SNAP asked the senators to advocate: An additional $100 billion for hospitals. Forgiveness for money provided to hospitals through the federal CARES Act’s Accelerated and Advance Payment Program. An increase in the federal Medicaid matching rate (FMAP). An increase in states’ Medicaid disproportionate share (Medicaid DSH) allotments and a delay in the scheduled implementation of Medicaid DSH allotment cuts to the states. Action to prevent implementation of the Medicaid fiscal accountability regulation. A moratorium on changes in hospital eligibility for the 340B prescription drug discount program, Medicare indirect … Read More

Posted in 340b, Coronavirus, COVID-19, Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania

COVID-19 Update: March 31, 2020

Coronavirus Update: March 31, 2020. COVID-19-related developments in Pennsylvania as of 4:00 p.m. on Tuesday, March 31.  To receive this daily update directly, sign up for our mailing list at State Update Governor Wolf                                                                                                      Today, Governor Wolf announced that the President approved part of his request for a major disaster declaration to support state, county, and local responses to COVID-19.  Included in the approved requests are reimbursement of up to 75 percent of eligible expenses (staff overtime, supplies, equipment) related to COVID-19 response for all levels of state government and private non-profits that qualify and direct federal assistance for materials and supplies to state and local governments.  Staff from the Pennsylvania Emergency Management Agency will be contacting potential applicants in … Read More

Posted in Coronavirus, COVID-19, Federal Medicaid issues, Medicare

COVID-19 Update: March 24, 2020

The following is a summary of the major COVID-19-related developments in Pennsylvania as of 4:45 today. For your convenience, copies of our daily updates are also posted to the SNAP Blog available here. State Updates The State Legislature The legislature continues to deliberate on a number of measures to respond to the COVID-19 crisis.  Among the issues being discussed between the administration and legislature are: Declaring a public health emergency and providing funding to respond to the crisis. Advancing telemedicine legislation. Amending the rules of unemployment compensation during an emergency declaration such as easing work search requirements and extending the length of time that benefits are available. Providing assistance to small businesses and non-profits through the Pennsylvania Industrial Development Authority. … Read More

Posted in Coronavirus, COVID-19, Federal Medicaid issues, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19
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2012 Safety-Net Association of Pennsylvania