Sec. 416. Annual Medicaid DSH report

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Section 1923 of the Social Security Act ( 42 U.S.C. 1396r–4 ) is amended by adding at the end the following: Beginning January 1, 2015, and annually thereafter, the Secretary shall submit a report to Congress on the program established under this section for making payment adjustments to disproportionate share hospitals for the purpose of providing Congress with information relevant to determining an appropriate level of overall funding for such payment adjustments during and after the period in which aggregate reductions in the DSH allotments to States are required under paragraphs

(7)and

(8)of subsection (f). Except as otherwise provided, each report submitted under this subsection shall include the following: Information and data relating to changes in the number of uninsured individuals for the most recent year for which such data are available as compared to 2013 and as compared to the Congressional Budget Office estimates of uninsured individuals made at the time of the enactment of the Patient Protection and Affordable Care Act ( Public Law 111–148 ) and the Health Care and Education Reconciliation Act of 2010 ( Public Law 111–152 ). Information and data relating to the extent to which hospitals continue to incur uncompensated care costs from providing unreimbursed or under-reimbursed services to individuals who either are eligible for medical assistance under the State plan under this title or under a waiver of such plan or who have no health insurance (or other source of third party coverage) for such services. Information and data relating to the extent to which hospitals continue to provide charity care and unreimbursed or under-reimbursed services, or otherwise incur bad debt, under the program established under this title, the State Children's Health Insurance Program established under title XXI, and State or local indigent care programs, as reported on cost reports submitted under title XVIII or such other data as the Secretary determines appropriate. In the first report submitted under this section, a methodology for estimating the amount of unpaid patient deductibles, copayments and coinsurance incurred by hospitals for patients enrolled in qualified health plans through an American Health Benefits Exchange, using existing data and minimizing the administrative burden on hospitals to the extent possible, and in subsequent reports, data regarding such uncompensated care costs collected pursuant to such methodology. For each State, information and data relating to the difference between the DSH allotment for the State for the fiscal year that began on October 1 of the year preceding the year in which the report is submitted and the aggregate amount of uncompensated care costs for all disproportionate share hospitals in the State. Information and data relating to the extent to which there are certain vital hospital systems that are disproportionately experiencing high levels of uncompensated care and that have multiple other missions, such as a commitment to graduate medical education, the provision of tertiary and trauma care services, providing public health and essential community services, and providing comprehensive, coordinated care. Such other information and data relevant to the determination of the level of funding for, and amount of, State DSH allotments as the Secretary determines appropriate There is authorized to be appropriated to the Secretary for the period of fiscal years 2015 through 2019, such sums as may be necessary to carry out this subsection. .

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42 USC 1396r–4
Pub. L. 111-148
Pub. L. 111-152

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Sec. 416

Annual Medicaid DSH report

Cite42 USC 1396r–4

Pub. L.Pub. L. 111-148

Pub. L.Pub. L. 111-152

Cites 3Cited by 0 across 0 sources