/ en Fri, 02 May 2025 06:36:03 -0500 Tue, 29 Apr 25 14:48:12 -0500 /news/headline/2025-04-29-supreme-court-sides-hhs-case-undercounting-ssi-eligible-recipients-dsh-formula <p>The Supreme Court April 29 <a href="https://www.supremecourt.gov/opinions/24pdf/23-715_5426.pdf" title="Supco ruling">ruled</a> 7-2 in favor of the Department of Health and Human Services in a case that challenged how HHS applied Congress鈥� formula for calculating Medicare Disproportionate Share Hospital payments. The formula includes a fraction that counts supplemental security income-eligible Medicare beneficiaries in the numerator and the total Medicare-eligible population in the denominator. The court upheld HHS鈥檚 longstanding position that if a patient is ineligible for a monthly cash benefit under SSI, a hospital cannot count that person towards the SSI portion of its DSH fraction.  <br> <br>The AHA last year filed an <a href="/amicus-brief/2024-08-14-aha-amicus-brief-supreme-court-urging-correction-hhs-undercounting-ssi-eligible-recipients-dsh-formula" title="amicus">amicus brief</a> in the case, arguing that HHS was undercounting the number of SSI-eligible Medicare beneficiaries by claiming patients are 鈥渆ntitled to鈥� SSI benefits only if they actually receive SSI benefits, which lowers the numerator in the formula and results in smaller payments.  </p> Tue, 29 Apr 2025 14:48:12 -0500 Medicare DSH /news/headline/2024-12-09-bipartisan-letter-calling-prevention-medicaid-dsh-cuts-gets-signatures-182-members-congress <p>A House Dear Colleague letter calling on House leadership to address scheduled Medicaid Disproportionate Share Hospital payment cuts received <a href="/system/files/media/file/2024/12/final-medicaid-dsh-letter-12-9-2024.pdf" target="_blank">signatures from 182 bipartisan members of Congress</a>. The letter was circulated by Reps. Dan Crenshaw, R-Texas, Yvette Clarke, D-N.Y., Gus Bilirakis, R-Fla., and Diana DeGette, D-Colo. The cuts, scheduled to take effect Jan. 1, total $8 billion. The AHA has asked Congress to provide relief from the reductions.</p> Mon, 09 Dec 2024 16:09:29 -0600 Medicare DSH /lettercomment/2024-11-26-aha-comments-cms-fy-2025-wage-index-values <div class="container"><div class="row"><div class="col-md-8"><p>November 26, 2024</p><p>The Honorable Chiquita Brooks-LaSure<br>Administrator<br>Centers for Medicare & Medicaid Services<br>Hubert H. Humphrey Building<br>200 Independence Avenue, S.W.<br>Room 445-G<br>Washington, DC 20201</p><p><em><strong>RE: CMS-1808-IFC, Changes to the Fiscal Year 2025 Hospital Inpatient Prospective Payment System (IPPS) Rates Due to Court Decision, (Vol. 89, No. 192), Oct. 3, 2024.</strong></em></p><p>Dear Administrator Brooks-LaSure:</p><p>On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, our clinician partners 鈥� including more than 270,000 affiliated physicians, 2 million nurses and other caregivers 鈥� and the 43,000 health care leaders who belong to our professional membership groups, the 黑料正能量 Association (AHA) appreciates the opportunity to comment on the Centers for Medicare & Medicaid Services鈥� (CMS) hospital inpatient prospective payment system (PPS) interim final action with comment period revising the Medicare wage index values for fiscal year (FY) 2025.</p><p>In FY 2020, CMS implemented a policy to increase the wage indices for certain hospitals with low wage index values. This was done in a budget-neutral manner through an adjustment applied to the standardized amounts for all hospitals. Specifically, the agency increased the wage index for hospitals with a wage index value below the 25th percentile by half the difference between their otherwise applicable wage index value and the 25th percentile wage index value across all hospitals for that year. The agency stated at the time that it intended to implement the policy for at least four years. The agency subsequently extended this low wage index policy and its related budget neutrality adjustment through FY 2024 and 2025.</p><p>However, when extending the policy in the FY 2025 final rule, CMS noted that the policy has been the subject of pending litigation. On July 23, 2024, the Court of Appeals for the D.C. Circuit held that the secretary lacked authority to adopt the policy for FY 2020 and that the policy and related budget neutrality adjustment must be vacated. As a result of this court decision, in this interim final action with comment period, the agency is removing the low wage index policy for FY 2025 and its related budget neutrality factor. However, the agency did not indicate if and how it would address the policy for FYs 2020-2024.</p><p>The AHA has long stated that while we appreciated CMS鈥� recognition of the wage index鈥檚 shortcomings, the agency should not have implemented this policy by penalizing all hospitals, especially when Medicare already pays far less than the cost of providing care. <strong>As such, if CMS does address payments under this policy in FYs 2020-2024, it should not seek a clawback of funds that hospitals received because of the agency鈥檚 mistakes and have long since spent on patient care. </strong>These funds supported low-wage hospitals during the COVID-19 pandemic and increased payments by roughly $300 million for the first year of policy.<sup>1</sup> This included helping nearly 800 rural hospitals when rural hospital closures hit an all-time high, with 19 hospitals closing in 2020 and two additional closures in 2021.<sup>2,3</sup> To help ensure the financial viability of hospitals, including rural hospitals, the agency should not seek a clawback of these funds.</p><p>At oral argument in the D.C. Circuit, the Department of Health and Human Services (HHS) counsel was asked whether there was a 鈥渟cenario where the low budget hospitals that have gotten money would get to keep the money.鈥� Counsel did not state that a clawback is legally required. Instead, counsel answered that the secretary had not yet determined that a clawback is required and that it is 鈥渘ot clear why the Secretary would need to go out鈥� and make such a clawback. Based on its regulations, we presume that CMS will adhere to the position it stated in court. See 42 CFR 搂 412.64(l) (鈥淚f a judicial decision reverses a CMS denial of a hospital鈥檚 wage data revision request, CMS pays the hospital by applying a revised wage index that reflects the revised wage data as if CMS's decision had been favorable rather than unfavorable.鈥�); 42 CFR 搂 412.64(k) (鈥淓xcept as provided in paragraph (k)(2)(ii) of this section, a midyear correction to the wage index is effective prospectively from the date the change is made to the wage index.鈥�). After all, the inpatient PPS process is, as its name suggests, a 鈥減rospective鈥� payment program, and nothing in the text of 42 U.S.C. 搂 1395ww(d)(3)(E) gives CMS the authority to claw back funds following an adverse judicial decision.<sup>4</sup></p><p>We appreciate your consideration of these issues. Please contact me if you have questions or feel free to have a member of your team contact Shannon Wu, AHA鈥檚 director for payment policy, at (202) 626-2963 or swu@aha.org.</p><p>Sincerely,</p><p>/s/</p><p>Ashley B. Thompson<br>Senior Vice President<br>Public Policy Analysis and Development</p><hr><ol><li><small>FY 2020 Final Rule</small></li><li><small>FY 2020 Final Rule</small></li><li><small>https://www.shepscenter.unc.edu/programs-projects/rural-health/rural-hospital-closures/</small></li><li><small>See generally Georgetown Univ. Hosp. v. Bowen, 821 F.2d 750, 758 (D.C. Cir. 1987) (鈥淚n amending the statute, both Houses of Congress made it abundantly clear that this authority was to be exercised on a prospective basis only: 鈥榌The authority] to set limits on costs . . . would be exercised on a prospective, rather than retrospective, basis so that the provider would know in advance the limits to Government recognition of incurred costs and have the opportunity to act to avoid having costs that are not reimbursable.鈥� Senate Report at 188; House Report at 83鈥�); Washington Hosp. Ctr. v. Bowen, 795 F.2d 139, 142 n.2 (D.C. Cir. 1986) (explaining that a prospective payment system is 鈥渘ot subject to retroactive adjustment鈥�); Louisiana Dep鈥檛 of Health & Hosps. v. U.S. Dep鈥檛 of Health & Human Servs., 566 F. App鈥檟 384, 387 (5th Cir. 2014) (discussing the differences between prospective and retrospective payment systems); Alexander County Hosp. v. Bowen, 692 F.Supp. 606, 609 (W.D.N.C. 1988) (鈥淭hus, under both the APA and the Medicare Act, the Secretary鈥檚 authority for rulemaking is prospective, not retrospective. To hold otherwise would give the Secretary unfettered discretion in enacting regulations that give retroactive effect to any or every change that is made in formulas for determining reimbursable costs.鈥�); cf. Paladin Community Mental Health Center v. Sebelius, 684 F.3d 527, 531 n.3 (5th Cir. 2012) (鈥淸F]orcing the Secretary to retroactively alter payment rates for various covered services鈥攅.g., payment rates that are adjusted annually and are required to remain budget neutral鈥攚ould likely wreak havoc on the already complex administration of Medicare Part B's outpatient prospective payment system.鈥�).</small></li></ol></div><div class="col-md-4"><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2024/11/2024-11-25-FY2025-IPPS-Interim-Final-Rule-Wage-Index-f.pdf" target="_blank" title="Click here to download the AHA Comments to CMS on FY 2025 Wage Index Values letter PDF.">Download the Letter PDF</a></div><p><a href="/system/files/media/file/2024/11/2024-11-25-FY2025-IPPS-Interim-Final-Rule-Wage-Index-f.pdf" target="_blank" title="Click here to download the AHA Comments to CMS on FY 2025 Wage Index Valuesletter PDF."><img src="/sites/default/files/2024-11/AHA-Comments-to-CMS-on-FY-2025-Wage-Index-Values-Cover.png" data-entity-uuid data-entity-type="file" alt="AHA Comments to CMS on FY 2025 Wage Index Values letter page 1." width="604" height="783"></a></p></div></div></div> Tue, 26 Nov 2024 12:38:24 -0600 Medicare DSH /news/headline/2024-11-12-aha-urges-congress-act-key-priorities-hospitals-end-year <p>In <a href="/2024-11-12-aha-urges-congress-act-key-priorities-lame-duck-session" target="_blank">comments</a> Nov. 12 to majority and minority leaders of the House and Senate, the AHA requested that Congress act on key priorities for hospitals and health systems before the end of 2024. AHA urged Congress to continue providing relief from Medicaid Disproportionate Share Hospital Payment cuts; continue the Medicare-dependent Hospitals and Low-volume Adjustment programs that expire Dec. 31; reject site-neutral payment proposals; and pass the Improving Seniors鈥� Timely Access to Care Act (H.R. 8702/ S. 4532), legislation that would reduce the wide variation in prior authorization methods in the Medicare Advantage program. <br> <br>"Hospitals and health systems are experiencing significant financial pressures that challenge their ability to provide 24/7 care for the patients and communities they serve," said AHA President and CEO Rick Pollack. "Increased expenses for drugs and supplies, inflation and the mounting burden due to certain commercial health insurer denial and delay practices continue to strain hospitals and health systems. At the same time, underpayments in reimbursements from Medicare and Medicaid do not keep pace with these mounting costs and exacerbate the problems hospitals are having."  <br> <br>AHA also urged Congress to extend the hospital-at-home waiver for five years through 2029; mitigate scheduled physician reimbursement cuts for 2025; and pass the Safety from Violence for Healthcare Employees Act (H.R. 2584/S. 2768), legislation that would provide federal protections from workplace violence for hospital workers, similar to protections for airport and airline workers.</p> Tue, 12 Nov 2024 15:48:16 -0600 Medicare DSH /amicus-brief/2024-08-14-aha-amicus-brief-supreme-court-urging-correction-hhs-undercounting-ssi-eligible-recipients-dsh-formula <p class="text-align-center"><strong>No. 23-715</strong><br><strong>In the Supreme Court of the United States</strong><br> </p><p class="text-align-center">ADVOCATE CHRIST MEDICAL CENTER, et al.,<br>v.<br>XAVIER BECERRA, SECRETARY OF HEALTH AND HUMAN SERVICES<br>__________</p><p class="text-align-center"><em>ON WRIT OF CERTIORARI </em><br><em>TO THE UNITED STATES COURT OF APPEALS </em><br><em>FOR THE DISTRICT OF COLUMBIA CIRCUIT</em><br> </p><p class="text-align-center"><strong>BRIEF FOR AMERICAN HOSPITAL ASSOCIATION, ASSOCIATION OF AMERICAN MEDICAL COLLEGES, AMERICA鈥橲 ESSENTIAL HOSPITALS, CATHOLIC HEALTH ASSOCIATION, FEDERATION OF AMERICAN HOSPITALS, AND NATIONAL RURAL HEALTH ASSOCIATION AS AMICI CURIAE SUPPORTING PETITIONERS</strong><br> </p><table><tbody><tr><td>MORGAN L. RATNER<br>Counsel of Record<br>DANIEL J. RICHARDSON<br>SULLIVAN & CROMWELL LLP<br>1700 New York Avenue, N.W.<br>Suite 700<br>Washington, DC 20006<br>(202) 956-7522<br>ratnerm@sullcrom.com</td></tr></tbody></table><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p>View the detailed brief below.</p> Wed, 14 Aug 2024 14:52:05 -0500 Medicare DSH /news/headline/2024-08-14-aha-files-brief-supreme-court-urging-correction-hhs-undercounting-ssi-eligible-recipients-dsh-formula <p>The AHA, joined by five other national hospital associations, Aug. 14 filed an <a href="/amicus-brief/2024-08-14-aha-amicus-brief-supreme-court-urging-correction-hhs-undercounting-ssi-eligible-recipients-dsh-formula">amicus brief</a> urging the Supreme Court to correct the Department of Health and Human Services鈥� misinterpretation of the formula set by Congress to calculate Disproportionate Share Hospital (DSH) payments, which includes a Medicare fraction that counts supplemental security income-eligible Medicare beneficiaries in the numerator and the total Medicare-eligible population in the denominator. The AHA said that HHS is undercounting the number of SSI-eligible Medicare beneficiaries by claiming patients are "entitled to" SSI benefits only if they actually receive SSI benefits, which lowers the numerator in the formula, resulting in smaller payments.  <br> <br>HHS鈥� interpretation undermines the DSH program, AHA said, and is inconsistent with a previous Supreme Court ruling in <em>Becerra v. Empire Health Foundation</em> in which HHS successfully argued that a patient is 鈥渆ntitled to鈥� Medicare under the DSH formula if they are qualified for Medicare, regardless of whether Medicare paid for the hospital stay. "But despite that victory, HHS has refused to apply the same logic to determine whether a patient is 'entitled to' SSI benefits 鈥� even though Congress used the same words in the same sentence," the brief notes. "That approach is textually indefensible, and it significantly undercounts the needy patients served by America鈥檚 hospitals." If this misinterpretation stands uncorrected, hospitals are estimated to lose more than a billion dollars annually in DSH payments, according to the brief. 鈥淲hat鈥檚 more, a hospital鈥檚 eligibility for DSH payments affects its entitlement to other federal benefits designed to help hospitals 鈥榩rovide a wide range of medical services鈥� to vulnerable populations," the brief added. <br> <br>The Association of American Medical Colleges, America's Essential Hospitals, the Catholic Health Association, the Federation of 黑料正能量s and the National Rural Health Association joined AHA in the filing. The AHA and fellow amici filed an amicus brief at the cert petition stage in February advocating for the Supreme Court to take up the issue for <a href="/news/headline/2024-02-02-aha-others-urge-supreme-court-review-challenge-hhs-interpretation-dsh-formula">review</a>.</p> Wed, 14 Aug 2024 14:24:09 -0500 Medicare DSH /lettercomment/2024-07-25-aha-comments-potential-dsh-cuts-ipps-final-rule-fy-2025 <div class="container"><div class="row"><div class="col-md-8"><p>July 25, 2024</p><p>The Honorable Chiquita Brooks-LaSure<br>Administrator<br>Centers for Medicare & Medicaid Services<br>Hubert H. Humphrey Building<br>200 Independence Avenue, S.W.<br>Room 445-G<br>Washington, DC 20201</p><p><em><strong>Re: FY 2025 Inpatient Prospective Payment Systems for Acute Care Hospitals; Disproportionate Share Hospital Payments</strong></em></p><p>Dear Administrator Brooks-LaSure:</p><p>On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, our clinician partners 鈥� including more than 270,000 affiliated physicians, 2 million nurses and other caregivers 鈥� and the 43,000 health care leaders who belong to our professional membership groups, the 黑料正能量 Association (AHA) remains deeply concerned over the Centers for Medicare & Medicaid Services鈥� (CMS) policies related to disproportionate share hospital (DSH) payments under the inpatient prospective payment system (IPPS). Specifically, any cuts to hospitals鈥� DSH payments would threaten their ability to continue providing essential services for their communities. As such, in the agency鈥檚 upcoming fiscal year (FY) 2025 IPPS final rule, we urge CMS to maintain the uninsured rate at its proposed level of 8.7%. Doing so would provide critical stability for DSH hospitals that serve low-income, uninsured and historically marginalized populations.</p><p>In the FY 2025 IPPS proposed rule, CMS proposed an uninsured rate of 8.7% based on projections from National Health Expenditure Accounts (NHEA) historical data.<a href="#fn1"><sup>1</sup></a> However, updated NHEA data<a href="#fn2"><sup>2</sup></a> indicate that CMS will finalize a substantially lower uninsured rate of 7.6% in the FY 2025 IPPS final rule, which will lead to DSH payment cuts for hospitals once again. Indeed, as shown below, over the past two years, the uninsured rate has fluctuated by at least a percentage point between the proposed and final rules, leading to uncertainty and instability in DSH payments for those hospitals that act as safety nets for low-income and uninsured populations. We note that data and projections that have previously worked when coverage levels were more stable may no longer be adequate during these times of turmoil.</p><p><img data-entity-uuid="e2796062-5bcd-44bd-9caf-2f7237195822" data-entity-type="file" src="/sites/default/files/inline-images/Uninsured-Rates-in-Proposed-and-Final-IPPS-Rules-20240725.png" width="1072" height="647" alt="Uninsured Rates in Proposed and Final IPPS Rules."></p><p>In last year鈥檚 FY 2024 final rule, as a response to some of AHA鈥檚 concerns, the agency directed readers to NHEA projections and methodologies. It also directed readers to the Office of the Actuary鈥檚 (OACT) memorandum certifying the rate of uninsured. However, as we stated at the time, these documents are not transparent and do not provide sufficient detail. Specifically, there remains a significant lack of transparency over how the effects of the pandemic and the subsequent Medicaid redetermination process are added to NHEA鈥檚 model estimate. Indeed, the AHA since 2021 has expressed concerns over CMS鈥� lack of transparency regarding how it and the OACT are calculating DSH payments. The agency continues to withhold relevant information from the public, thereby depriving the AHA and others of the ability to comment on the basis for the agency鈥檚 decision. Without additional information regarding the OACT analysis, stakeholders can neither validate nor evaluate the complex calculations CMS has made in estimating the percent of uninsured and other factors used to determine DSH payments.</p><p>In a year with continued turbulent coverage losses, we urge CMS to carefully reconsider its reliance on current data sources and methodologies to estimate the rate of the uninsured. However, in the meantime, to provide stability to hospitals caring for patients, we urge CMS to finalize the uninsured rate as proposed 鈥� at 8.7% 鈥� for purposes of its FY 2025 DSH calculations.</p><p>Please contact me if you have questions or feel free to have a member of your team contact Shannon Wu, AHA鈥檚 director of policy, at swu@aha.org.</p><p>Sincerely,</p><p>/s/</p><p>Ashley B. Thompson<br>Senior Vice President<br>Public Policy Analysis and Development</p><hr><ol><li id="fn1">We disagreed with this estimate given ongoing Medicaid redeterminations and other issues, as we stated in our <a href="/lettercomment/2024-06-05-aha-comments-cms-inpatient-payment-proposal-fy-2025">comment letter</a>.</li><li id="fn2"><a href="https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/nhe-fact-sheet" target="_blank">https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/nhe-fact-sheet</a></li></ol></div><div class="col-md-4"><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2024/07/AHA-Comments-on-Potential-DSH-Cuts-in-IPPS-Final-Rule-for-FY-2025.pdf" target="_blank" title="Click here to download the AHA Comments on Potential DSH Cuts in IPPS Final Rule for FY 2025 letter PDF.">Download the Letter PDF</a></div><p><a href="/system/files/media/file/2024/07/AHA-Comments-on-Potential-DSH-Cuts-in-IPPS-Final-Rule-for-FY-2025.pdf" target="_blank" title="Click here to download the AHA Comments on Potential DSH Cuts in IPPS Final Rule for FY 2025 letter PDF."><img src="/sites/default/files/inline-images/Page-1-AHA-Comments-on-Potential-DSH-Cuts-in-IPPS-Final-Rule-for-FY-2025.png" data-entity-uuid="f115fd01-c61d-4dec-b72c-71a25442d338" data-entity-type="file" alt="AHA Comments on Potential DSH Cuts in IPPS Final Rule for FY 2025 letter page 1." width="692" height="900"></a></p></div></div></div> Thu, 25 Jul 2024 14:59:36 -0500 Medicare DSH /news/headline/2024-06-10-supreme-court-hear-case-challenging-hhs-interpretation-dsh-formula <p>The Supreme Court June 10 agreed to review a case challenging how the Department of Health and Human Services applies Congress鈥� formula for calculating Disproportionate Share Hospital payments. In February, the AHA and five other national hospital associations representing hospitals <a href="/news/headline/2024-02-02-aha-others-urge-supreme-court-review-challenge-hhs-interpretation-dsh-formula">urged</a> the Court to review the case. <br><br>鈥淭he AHA is pleased that the Supreme Court agreed to consider this case,鈥� said Chad Golder, AHA general counsel and secretary. 鈥淎s we explained in our amicus brief urging the Court to grant certiorari, it is critical to hospitals and health systems that HHS interpret the DSH fraction consistently across the statute. The agency鈥檚 longstanding failure to do so has cost hospitals more than a billion dollars each year, directly harming the hospitals that serve America鈥檚 most vulnerable patients. We look forward to the Supreme Court rectifying this legal error next term.鈥� <br><br>In February鈥檚 friend-of-the-court brief, the organizations argued that HHS incorrectly adopted the view that a patient is entitled to Supplemental Security Income benefits only if the patient actually received cash SSI payments during a hospital stay, an interpretation inconsistent with the Court鈥檚 reasoning in Becerra v. Empire Health Foundation. <br><br>鈥淭his case concerns a question that is critical to calculating the Medicare DSH fraction: When are patients 鈥榚ntitled to鈥� SSI benefits and so counted in the numerator? Is it when they are eligible for SSI benefits, or when they are actually receiving cash SSI benefits,鈥� the organizations <a href="/system/files/media/file/2024/02/aha-others-amicus-brief-for-advocate-christ-medical-center-et-al-vs-xavier-becerra-secretary-of-health-and-human-services.pdf">wrote</a>. <br><br>鈥淭he correct interpretation of the DSH formula is vitally important to America鈥檚 hospitals,鈥� the brief adds. 鈥淎lthough HHS has refused to share the data that would allow hospitals to accurately count the SSI-eligible patients whom the agency鈥檚 approach excludes, the available estimates suggest that hospitals will lose more than a billion dollars each year in DSH funds. What鈥檚 more, a hospital鈥檚 eligibility for DSH payments affects its entitlement to other federal benefits designed to help hospitals 'provide a wide range of medical services' to vulnerable populations. ... HHS鈥檚 error thus has far-reaching implications for hospitals, patients, and the American healthcare system.鈥� </p> Mon, 10 Jun 2024 15:42:30 -0500 Medicare DSH /news/perspective/2024-02-15-making-our-voice-heard-and-leading-way-advance-health-america <p>Two presidents that America honors with a federal holiday on Monday shared a number of memorable traits. George Washington and Abraham Lincoln were blessed with the gifts of vision, courage and leadership 鈥� qualities that played a central role in guiding the country through the enormous challenges of their times.</p><p>Both men also understood the power of words and ideas to inspire their fellow citizens and light the fire of progress. The American ideal of democracy is the enduring legacy of Washington, and the fact that we are still the <em>United</em> States of America is due to Lincoln鈥檚 refusal to allow the nation to split apart.</p><p>It is important for us to continue to exercise the principles of democracy that Washington and the Founding Fathers fought so hard for and speak up, asking hard questions of candidates in this election year and evaluating their thinking on the issues that affect our field.</p><p>To that end, AHA鈥檚 <a href="https://wecarewevote.aha.org/" title="We Care We Vote">We Care We Vote</a> is an opportunity to encourage good citizenship through voter registration and participation in the electoral process.</p><p>Our initiative suggests questions that place a candidate on record about many of the issues most important to our field, such as: What actions have you taken to support your hospitals and health systems during these uncertain times? What efforts do you support to address the ongoing health care worker shortage and protect health care workers from rising rates of physical and verbal abuse? What proposals do you support to expand access to behavioral health care?</p><p>Their answers matter a great deal.</p><p>During this political season, we must also make clear to our elected officials that despite the challenges we face, we are united as a field in facing similar issues and having common solutions regardless of location, size, ownership, or type of hospital.</p><p><em>This means</em> a united front in favor of preserving the moratorium on Medicaid disproportionate share hospital cuts and staving off harmful so-called site-neutral payment policies that don鈥檛 account for the differences in the care hospitals provide 24/7.</p><p><em>This means</em> continuing to shine a spotlight on the practices of some commercial insurers that do not meet the letter or spirit of the law in terms of the coverage they provide.</p><p><em>This means</em> pushing back against chronic underpayments from Medicare that do not meet the cost of care, continue to put hospitals鈥� ability to provide quality and accessible care 24/7 to all who need it at risk, and hobble hospitals鈥� ability to fight growing cybersecurity threats, reinvest in people and communities, expand or upgrade facilities, or to pursue the research and technological advances that advance health for all.</p><p>There is no light between us on these and many other issues.</p><p>To paraphrase Abraham Lincoln, the better angels of our nature are the dedicated caregivers who do their best every minute of the day for the people and communities they serve.</p><p>This President鈥檚 Day, let鈥檚 put the tools of democracy and unity to use once again, and stand firm for the future of America鈥檚 health care.</p> Thu, 15 Feb 2024 15:42:19 -0600 Medicare DSH /news/headline/2024-02-02-aha-others-urge-supreme-court-review-challenge-hhs-interpretation-dsh-formula <p>The AHA, joined by five other national associations representing hospitals, Feb. 2 urged the U.S. Supreme Court to review a case challenging how the Department of Health and Human Services applies Congress鈥� formula for calculating Disproportionate Share Hospital payments. In a <a href="/amicus-brief/2024-02-02-aha-others-amicus-brief-support-advocate-christ-medical-center-et-al-v-xavier-becerra-secretary-health">friend-of-the-court brief</a>, the organizations said HHS has adopted the view that a patient is entitled to Supplemental Security Income benefits only if the patient actually received cash SSI payments during a hospital stay, an interpretation that is inconsistent with the Supreme Court鈥檚 reasoning in Becerra v. Empire Health Foundation and continues the agency鈥檚 鈥渓ong history of undermining the DSH program.鈥�<br><br>鈥淭he correct interpretation of the DSH formula is vitally important to America鈥檚 hospitals,鈥� the brief adds. 鈥淎lthough HHS has refused to share the data that would allow hospitals to accurately count the SSI-eligible patients whom the agency鈥檚 approach excludes, the available estimates suggest that hospitals will lose more than a billion dollars each year in DSH funds. What鈥檚 more, a hospital鈥檚 eligibility for DSH payments affects its entitlement to other federal benefits designed to help hospitals 鈥榮tretch scarce Federal resources,鈥� including the 340B Drug Discount Program. 鈥� HHS鈥檚 error thus has wide-reaching implications for hospitals, patients, and the American healthcare system."<br><br>The Association of American Medical Colleges, America鈥檚 Essential Hospitals, Catholic Health Association, Federation of 黑料正能量s, and National Rural Health Association joined AHA in the brief.</p> Fri, 02 Feb 2024 16:01:00 -0600 Medicare DSH