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By Ginger - Site Admin on Wednesday, March 20, 2019 11:01 AM
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...
By Ginger - Site Admin on Monday, March 18, 2019 11:59 AM
In correspondence dated December 31, 2018, in light of four recent appellate court decisions, the Centers for Medicare and Medicaid Services (CMS) is withdrawing questions 33 & 34 from the Medicaid Disproportionate Share Hospital (DSH) guidance that was issued in January 2010 titled, “Additional Information on the DSH Reporting and Audit Requirements,” available at: https://www.medicaid.gov/medicaid/finance/downloads/part-1-additional-info-on-dsh-reporting-and-auditing.pdf.

As a result, frequently asked questions (FAQs) 33 and 34 are no longer operative, which means payments received from third-party payors on claims for Medicaid eligible patients will no longer be offset in determining Uncompensated Care.

CMS will accept revised DSH audits that cover hospitals' services furnished before June 2, 2017. CMS has not yet given up arguing their case for the periods...
By Ginger - Site Admin on Wednesday, January 30, 2019 10:35 AM
After receiving input from the KHA Hospital Reimbursement Committee, the Association submitted comments to the Office of Legislative and Regulatory Affairs regarding disproportionate share hospital (DSH) distributions.

After KHA's collaboration with hospitals and the Department for Medicaid Services (DMS) to modernize the DSH payment program, KHA members subsequently identified concerns once they had an opportunity to review the Department's proposed changes to the regulation. Some changes simply need clarification while others are not in keeping with the prior agreement on how the DSH program will operate.

The new regulation allows the DMS to adjust a hospital's total uncompensated care costs reported on the hospital's base year Medicaid DSH survey used to make the initial DSH payment. This gives very broad authority to allow the Department to adjust a hospital's total uncompensated care costs "if the amount reported appears likely to result in a substantial redistribution of DSH funds that...
By Ginger - Site Admin on Tuesday, January 08, 2019 2:22 PM
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.



...
By Ginger - Site Admin on Tuesday, June 26, 2018 8:45 AM
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....
By Ginger - Site Admin on Tuesday, October 03, 2017 8:20 AM

The status of the Disproportionate Share Hospital (DSH) surveys for respective State Fiscal Years (SFY) is now available. Several facilities are listed for the 2014 reviews and are requested to submit their information as soon as possible if they have not. 

Final settlements and resolution of appeals of prior SFYs are currently underway in abeyance pending the result of ongoing litigation at the federal level regarding payments from Third-party Payors.

By Ginger - Site Admin on Friday, August 04, 2017 8:22 AM
On Wednesday, the Centers for Medicare and Medicaid Services (CMS) released its Medicare inpatient hospital prospective payment system (IPPS) final rule for fiscal year 2018. This rule will significantly change the methodology for making Medicare disproportionate share hospital (DSH) payments. The new methodology will be phased in over three years. Preliminary estimates are that the new methodology will reduce Medicare DSH payments to Kentucky hospitals by about $77 million when the new method is fully in place in fiscal year (FY) 2020. KHA filed comments strongly objecting to these changes. Please note, this methodology only affects hospitals paid on a DRG basis, who also qualify for Medicare DSH.

Summary of Medicare DSH Changes

Hospitals that qualify for Medicare DSH payments will continue to receive 25 percent of the Medicare DSH funds under the pre-FY 2014 DSH formula, known as the empirically justified DSH payments. The remaining 75 percent of payments, which are paid from a...
By Ginger - Site Admin on Thursday, September 15, 2016 8:24 AM
On September 14, KHA submitted comments to the Centers for Medicare and Medicaid Services (CMS) on the proposed Medicaid disproportionate share hospital (DSH) rule addressing the treatment of third-party payers in calculating uncompensated care costs.

KHA and Kentucky's hospitals disagree with the position of CMS to require counting payments from Medicare and other private insurers to calculate uncompensated care costs for retention of DSH payments. The proposed rule would redefine a hospital's cost of care and is not authorized by statute.

The law states clearly that the only costs counted are Medicaid payments and payments made by uninsured patients, not payments made by other programs or insurers.

This proposal would harm many safety net hospitals, and would have devastating consequences for Kentucky's rural hospitals.

For a full copy of the comments, visit the Policy page in the Advocacy section of www.kyha.com.

If you have any questions,...
By Ginger - Site Admin on Monday, September 15, 2014 10:47 AM

The Department of Medicaid has confirmed that the ten percent holdback of the November 2013 Medicaid Disproportionate Share Hospital (DSH) payments were mailed September 22.

The final share factor used to distribute the balance of DSH funds for the November 2013 distribution is the same share factor that will be used by Medicaid when making the DSH payments for November 2014 and November 2015. Since the Federal funding has not changed for the next two years, and the share factor is constant, the Medicaid DSH payments for the next two years should be essentially the same as the payment for November 2013.

If you have any questions, please contact Steve Miller at KHA (502-426-6220 or 800-945-4542 or via email at smiller@kyha.com).


By Ginger - Site Admin on Tuesday, April 15, 2014 8:09 AM
On Monday, April 7, Myers and Stauffer, the contractor conducting the Medicaid Disproportionate Share Hospital (DSH) Audits for Kentucky Medicaid, distributed to hospitals by mail the fee for service (FFS) crossover and managed care organization (MCO) paid claims listing needed to complete the data submission required for the Medicaid DSH Surveys. The revised due date for the DSH survey is now April 25.

Hospitals are encouraged to submit the most complete and accurate data possible, keeping in mind the definition of uncompensated care. The 2011 audit year is the first year that hospitals may be subject to return a portion of their DSH payments if they are unable to document uncompensated care cost in excess of their Medicaid DSH payments received. In prior years since the findings were informational and hospitals were not subject to recoupments, many hospitals may not have filed all uncompensated care cost. Instead, they just filed enough cost to “cover” the amount of Medicaid DSH received.

...
By Ginger - Site Admin on Friday, March 14, 2014 8:49 AM
Myers and Stauffer, under contract with Kentucky Medicaid, has begun the federal fiscal year (FFY) 2011 Medicaid Disproportionate Share Hospital (DSH) audits. Information was distributed to hospitals in early February with a due date of March 21. Hospitals have already received the Medicaid fee-for-services paid claims listing, with Medicare/Medicaid cross-overs and managed care claims to be distributed soon. An extension of the March 21 due date will probably be granted due to the late distribution of the additional paid claims listing.

Hospitals are encouraged to submit the most complete and accurate data possible, keeping in mind the definition of uncompensated care. The 2011 audit year is the first year that hospitals may be subject to return a portion of their DSH payments if they are unable to document uncompensated care cost reported on the survey. In prior years, since the findings were informational and hospitals not subject to recoupments, many hospitals may not have filed all uncompensated...
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