The Department for Medicaid Services (DMS) responded to the comments submitted by KHA on proposed changes to the regulation governing hospital disproportionate share distributions, and they have agreed to revise the regulation in the most critical areas as recommended by KHA .

Specifically, and most importantly, the proposed rule would have denied a hospital from receiving a final DSH payment if that hospital failed to submit an updated DSH survey. KHA took issue with this proposal since there is no statutory authority to eliminate a DSH payment so long as the hospital has submitted a DSH survey. The only statutory penalty is a reduction of 20% in the amount of the final payment if the survey is submitted late. KHA also commented that resubmission of an original DSH survey would be burdensome if there were no changes. KHA is pleased that DMS agreed to amend the regulation to (1) delete its proposal to suspend or recoup a DSH payment if a DSH survey was not updated and (2) allow a hospital...

The Centers for Medicare & Medicaid Services last week withdrew a 2010 Medicaid DSH policy, known as FAQs 33 and 34, that included private insurance and Medicare payments when calculating the Medicaid shortfall component of the hospital-specific limit on disproportionate share hospital payments. FAQs 33 and 34 “are no longer operative, and CMS will accept revised DSH audits that cover hospitals services furnished before June 2, 2017,” the agency said. CMS is appealing a federal court decision that barred it from enforcing the FAQs and a 2017 final rule incorporating the policy. “CMS will not be enforcing the 2017 rule … as long as the [court] decision remains operative in its current form,” the agency said.



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Timely visits were held with the Kentucky congressional delegation and staff in Washington, D.C., on July 12-13, by a team of KHA members and staff advocating for Kentucky’s hospitals. The visits were held a day after the U.S. House Energy and Commerce Health Subcommittee held hearings on the 340B Drug Discount Program, in which seven bills that have been introduced (and eight bills without named sponsors and yet to be introduced) were discussed. Some of the legislation is supportive of the 340B program and some favors the pharmaceutical industry.

Thanks to the KHA team who traveled to Washington including KHA Legislative Chair Nina Eisner, CEO of Ridge Behavioral Health; Sherri Craig, KentuckyOne Health; Karen Sellers, Highlands Regional Medical Center; Lourdes Baez, Baptist Health...

On June 25, KHA submitted comments to the Centers for Medicare and Medicaid Services (CMS) on the proposed fiscal year (FY) 2019 hospital inpatient prospective payment system (IPPS) rule.

While KHA was appreciative of many of the changes proposed by the rule, the Association has concerns about the agency's proposal to require publication of hospital chargemasters due to questions about its usefulness for consumers. The comments also offered suggestions to address calculation of Medicare disproportionate share hospital (DSH) payments and wage index disparities which are harming Kentucky hospitals.

A full copy of the comments is available on the Policy Issues page, found under Advocacy on the KHA website, www.kyha.com....

On September 8, KHA submitted comments to the Centers for Medicare and Medicaid Services (CMS) regarding the Medicare hospital outpatient prospective payment system (OPPS) proposed rule for calendar year (CY) 2018. The Association has significant concerns with this proposal's reductions in payment for 340B hospitals as well as changes to remove total knee replacement from the inpatient only list, which is unsafe and will negatively impact hospitals participating in the CMS Comprehensive Care for Joint Replacement (CJR) and the Bundled Payment for Care Improvements (BPCI) programs.

A copy of KHA's comments are available on the Policy page (members only) of www.kyha.com.

If you have any questions, please contact Nancy Galvagni at KHA (ngalvagni@kyha.com).