The Centers for Medicare & Medicaid Services has proposed altering its regulations governing the calculation of eligible hospitals’ Medicare disproportionate share payments (Medicare DSH).

According to CMS,

This proposed rule would revise our regulations on the counting of days associated with individuals eligible for certain benefits provided by section 1115 demonstrations in the Medicaid fraction of a hospital’s disproportionate patient percentage.

This is essentially the same change CMS included in its proposed FY 2022 and FY 2023 inpatient prospective payment system rules and then did not adopt in the final rule.  In proposing this change again CMS suggests that this has always been its policy and it therefore needs to update its regulations to reflect that since courts are finding that the existing regulations are contrary to this policy.

The Alliance of Safety-Net Hospitals continues to be concerned that this proposed policy could reduce Medicare DSH payments to hospitals.  Consequently, ASH most likely will submit comments to CMS on behalf of its members and community safety-net hospitals.

Learn more from CMS’s announcement of the proposed rule and from the formal Federal Register notice.  Stakeholder comments are due by May 1.