Sec. 1312. Reduction in Medicaid DSH

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Not later than January 1, 2018, the Secretary of Health and Human Services (in this title referred to as the Secretary ) shall submit to Congress a report concerning the extent to which, based upon the impact of the health care reforms carried out under this Act in reducing the number of uninsured individuals, there is a continued role for Medicaid DSH. In preparing the report, the Secretary shall consult with community-based health care networks serving low-income beneficiaries.

The report shall include the following: Recommendations regarding— the appropriate targeting of Medicaid DSH within States; and the distribution of Medicaid DSH among the States. The DSH Health Reform methodology described in paragraph

(2)of subsection

(b)for purposes of implementing the requirements of such subsection. The Secretary shall coordinate the report under this subsection with the report on Medicare DSH under section 1321. In this section, the term Medicaid DSH means adjustments in payments under section 1923 of the Social Security Act for inpatient hospital services furnished by disproportionate share hospitals. If there is a significant decrease in the national rate of uninsurance as a result of this Act (as determined under section 1321(a)(2)(A)), then the Secretary of Health and Human Services shall reduce Medicaid DSH so as to reduce total Federal payments to all States for such purpose by $1,500,000,000 in fiscal year 2019, $2,500,000,000 in fiscal year 2020, and $6,000,000,000 in fiscal year 2021. The Secretary shall carry out paragraph

(1)through use of a DSH Health Reform methodology issued by the Secretary that imposes the largest percentage reductions on the States that— have the lowest percentages of uninsured individuals (determined on the basis of audited hospital cost reports) during the most recent year for which such data are available; or do not target their DSH payments on— hospitals with high volumes of Medicaid inpatients (as defined in section 1923(b)(1)(A) of the Social Security Act ( 42 U.S.C. 1396r–4(b)(1)(A) )); and hospitals that have high levels of uncompensated care (excluding bad debt). Not later than the publication deadline specified in subparagraph (B), the Secretary shall publish in the Federal Register a notice specifying the DSH allotment to each State under 1923(f) of the Social Security Act for the respective fiscal year specified in such subparagraph, consistent with the application of the DSH Health Reform methodology described in paragraph (2). The publication deadline specified in this subparagraph is— January 1, 2018, with respect to DSH allotments described in subparagraph

(A)for fiscal year 2019; January 1, 2019, with respect to DSH allotments described in subparagraph

(A)for fiscal year 2020; and January 1, 2020, with respect to DSH allotments described in subparagraph

(A)for fiscal year 2021. Section 1923(f) of the Social Security Act ( 42 U.S.C. 1396r–4(f) ) is amended— by redesignating paragraph

(7)as paragraph (8); and by inserting after paragraph

(6)the following new paragraph: Notwithstanding paragraph (2), if the Secretary makes a reduction under section 1322(b)(1) of the Empowering Patients First Act of 2013 , the total DSH allotments for all States for— fiscal year 2019, shall be the total DSH allotments that would otherwise be determined under this subsection for such fiscal year decreased by $1,500,000,000; fiscal year 2020, shall be the total DSH allotments that would otherwise be determined under this subsection for such fiscal year decreased by $2,500,000,000; and fiscal year 2021, shall be the total DSH allotments that would otherwise be determined under this subsection for such fiscal year decreased by $6,000,000,000. . Section 1923(b)(4) of such Act ( 42 U.S.C. 1396r–4(b)(4) ) is amended by adding before the period the following: or to affect the authority of the Secretary to issue and implement the DSH Health Reform methodology under section 1322(b)(2) of the . Empowering Patients First Act of 2013 Section 1923(d) of the Social Security Act ( 42 U.S.C. 1396r–4 ) is amended by adding at the end the following new paragraph: No hospital may be defined or deemed as a disproportionate share hospital, or as an essential access hospital (for purposes of subsection (f)(6)(A)(iv)), under a State plan under this title or subsection

(b)of this section (including any waiver under section 1115) unless the hospital— provides services to beneficiaries under this title without discrimination on the ground of race, color, national origin, creed, source of payment, status as a beneficiary under this title, or any other ground unrelated to such beneficiary’s need for the services or the availability of the needed services in the hospital; and makes arrangements for, and accepts, reimbursement under this title for services provided to eligible beneficiaries under this title. . The amendment made by subsection

(a)shall be apply to expenditures made on or after July 1, 2014.

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42 USC 1396r–4(b)(1)(A)
42 USC 1396r–4(f)
42 USC 1396r–4(b)(4)
42 USC 1396r–4

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cites case law

Sec. 1312

Reduction in Medicaid DSH

Cite42 USC 1396r–4(b)(1)(A)

Cite42 USC 1396r–4(f)

Cite42 USC 1396r–4(b)(4)

Cite42 USC 1396r–4

Cites 4Cited by 0 across 0 sources