AHA to CMS: $1B Medicare DSH cut for FY 2024 ‘unacceptable’

AHA Aug. 9 called the Centers for Medicare & Medicaid Services’ $957 million cut to Medicare Disproportionate Share Hospitals for fiscal year 2024 “simply unacceptable,” citing the agency’s “remarkable lack of transparency” in how the inpatient prospective payment system final rule calculates the uninsured rate and its impact on DSH payments. While the rule directs readers to National Health Expenditures Account projections and methodologies and to an Office of the Actuary (OACT) memorandum certifying the rate of uninsured, “these documents do not provide nearly sufficient detail,” AHA wrote. 
 
“There has also been substantial research support to indicate that a significant proportion of those leaving Medicaid as a result of the redetermination process will not have other coverage, as we have previously commented. ... We know from HHS’s own public statements that it is concerned about these early trends. For this reason, it is implausible for us to understand OACT’s forecast of a decrease in the uninsured rate for next year during the Medicaid redetermination process.”