Manatt Health Partner Anne Karl was quoted in an article by Modern Healthcare on the potential financial complications that could affect hospitals in states that haven't expanded Medicaid coverage after the Centers for Medicare and Medicaid Services (CMS) proposed a hospital payment rule that could take away Medicare reimbursements hospitals earn by caring for needy patients.
The new rule would exclude certain uncompensated care pool days, which pay hospitals for taking care of uninsured or underinsured patients, from the Medicare Disproportionate Share Hospital (DHS) calculation. The payments from these uncompensated care pools would instead function as supplemental Medicaid DSH payments. The policy, if finalized, would have the largest effect on hospitals in states that haven't expanded Medicaid coverage, stated Karl, since these states have come to rely on the pools in place of the additional Medicaid matching funds that come with expansion. Public safety-net hospitals would be disproportionately hurt, especially as funding for COVID-19 relief programs slows. “This is going to be bad for hospitals in those states,” Karl concluded.