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MACPAC Issues Recommendations to Congress

The Medicaid and CHIP Payment and Access Commission has submitted its annual report to Congress on Medicaid and the Children’s Health Insurance Program. The report includes recommendations for: improving Medicaid’s responsiveness during economic downturns addressing concerns about high rates of maternal morbidity and mortality; reexamining Medicaid’s estate recovery policies integrating care for people who are dually eligible for Medicaid and Medicare improving hospital payment policy for the nation’s safety-net hospitals MACPAC is a non-partisan legislative branch agency that “provides policy and data analysis and makes recommendations to Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on a wide array of issues affecting Medicaid and the State Children’s Health Insurance Program (CHIP).”  Its mandate … Read More

Posted in Federal Medicaid issues

SNAP Asks PA Delegation for Help From COVID-19 Relief Bill

The next federal COVID-19 relief bill should include more resources for the Provider Relief Fund, SNAP has told members of Pennsylvania’s congressional delegation. The bill also should include additional targeted funding for safety-net hospitals, help with staffing, an extension of the current moratorium on the Medicare sequestration, and forgiveness for safety-net hospitals for loans they received under the Medicare Accelerated and Advance Payment Program. This was the message the Safety-Net Association of Pennsylvania conveyed last week in a letter to members of Pennsylvania’s congressional delegation.  See that letter here.

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

MACPAC Meets

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. MACPAC kicked off its January meeting with a review of a draft chapter for the March 2021 report to Congress and recommendations on a mandatory extension of Medicaid coverage for 12 months postpartum. The Commission received extensive public comment on the recommendations. On Friday, the Commission approved three recommendations as drafted related to postpartum coverage. The Commission recommended that Congress should: extend the postpartum coverage period for individuals who were eligible and enrolled in Medicaid while pregnant to a full year of coverage, regardless of changes in income. Services provided to individuals during the … Read More

Posted in Federal Medicaid issues, Pennsylvania safety-net hospitals

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

MACPAC Meets

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
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2012 Safety-Net Association of Pennsylvania