Part two of the Trump administration’s proposed FY 2020 budget brought more potential bad news for private safety-net hospitals.
Last week’s “lean budget” released by the White House included a number of challenges for private safety-net hospitals and this week’s release, intended to fill in some of the blanks that last week’s document left, brought more of the same.
Proposed Medicare challenges include:
- a call for establishing a new process for calculating Medicare disproportionate share (Medicare DSH) uncompensated care payments
- slashing Medicare bad debt reimbursement from 65 percent to 25 percent
- continued movement toward site-neutral payments for outpatient services provided at hospital outpatient facilities
Newly proposed Medicaid challenges include:
- extending Medicaid disproportionate share (Medicaid DSH) cuts beyond the currently planned six years
- redesigning the formula for allocating Medicaid DSH funds to the states
- authorizing states to verify beneficiaries’ Medicaid eligibility more than once a year
- permitting states to apply means tests to Medicaid eligibility
The latest FY 2020 budget proposal also calls for:
- consolidating Medicare, Medicaid, and children’s hospital medical education payments into single new capped medical education grant program
- reduced 340B prescription drug discount program payments for some hospitals
- reducing the grace period for payment of premiums for health insurance purchased on an insurance exchange
- income-based increases in premiums for low-cost insurance purchased on those exchanges
All of these changes, if implemented, would pose problems for NASH members and most private safety-net hospitals.
Learn more from this week’s White House budget document.
