Current
Disproportionate Share Hospital (DSH) Payments:
The three House Committees (Energy and Commerce, Ways and Means,
and Education and Labor) with jurisdiction over health care reform
legislation, completed marking up amended versions of“America’s
Affordable Health Choices Act of 2009” (H.R.
3200) before the August Congressional recess. Differences in
the three bills will need to be reconciled before they are combined
and introduced on the House floor. All three versions include language
that reduces Medicaid DSH payments by $10 billion over the next
ten years, starting in FY 2017 ($1.5 billion in FY 2017, $2.5 billion
in FY 2018, and $6 billion in FY 2019). They also the HHS Secretary
to issue recommendations regarding “the distribution of Medicaid
DSH among the states.”
At press time the Senate Finance Committee had not yet introduced
their health care reform package. The Finance committee package
is expected to contain language based on a July 8 joint health care
reform agreement negotiated by the White House, Senate Finance Committee
Chairman Max Baucus (D-Mont.), the American Hospital Association
(AHA), the Catholic Health Association (CHA), and the Federation
of American Hospitals (FAH). The agreement would phase in policies
to expand coverage by 95 percent of all Americans. To help achieve
this goal, the hospital community will contribute $155 billion over
10 years in the form of reduced Medicare hospital payments and reductions
in Medicare and Medicaid disproportionate share hospital (DSH) payments.
The DSH reductions will begin in 2015, and be linked to coverage
expansions. Under the agreement, approximately 60 percent of total
DSH payments would be preserved over 10 years.
In a July 8 statement,
AAMC President and CEO Darrell G. Kirch, M.D., praised the agreement
stating, “We greatly appreciate the thoughtful approach this
agreement takes to guarantee that the safety net remains intact
during the transition to a better [health care delivery] system.”
AAMC materials submitted to Obama transition team can be found
here.
Medicaid Outpatient Services Definition Rescinded:
On June 30, 2009, CMS rescinded
the agency’s December 28, 2007, final Medicaid rule entitled
“Clarification of Outpatient Hospital Facility (Including Hospital
Outpatient Clinic) Services Definition.” The rule would have
limited Medicaid reimbursement for hospital outpatient services
to those services reimbursed by the Medicare program. The AAMC supported
this rescission in a June 1, 2009, comment letter to the agency.
Medical Liability Reform
As a member of the Health Coalition on Liability and Access (HCLA),
the AAMC continues to support passage of comprehensive medical liability
reform legislation that includes:
- unrestricted awards for economic damages;
- a $250,000 cap on non-economic damages ("pain and suffering");
- capping punitive damages at the greater of $250,000 or twice
economic damages;
- limits on attorneys' contingency fees;
- joint and several liability reforms;
- no double recovery of damages; and
- payment of certain awards over time.
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AAMC Documents
Also on Government Affairs
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