Engel Applauds CMS Decision on Uncompensated Care Payments

Press Release

Congressman Eliot L. Engel, a senior member of the House Energy and Commerce Committee's Health Subcommittee, applauded the Centers for Medicare and Medicaid Services (CMS) for revising a proposal to redistribute Medicare Disproportionate Share Hospital (DSH) payments. Engel, working in conjunction with the New York hospital community and other members of New York's Congressional delegation, personally called on CMS to make this change to protect hospitals' ability to care for New York's most vulnerable populations.

CMS provides DSH payments to hospitals that serve a disproportionately high number of patients with socioeconomic challenges, such as Medicaid beneficiaries and the uninsured. These supplemental funds help hospitals mitigate the financial burden of serving these populations.

Earlier this year, CMS proposed a change to the way it calculates "uncompensated care." The suggested change would have used Medicare cost report (Worksheet S-10) data to estimate uncompensated care, which would have inadequately accounted for the uncompensated costs hospitals face. Historically, S-10 data has not been used for this purpose due to concerns about its quality and completeness. S-10 data is not audited and does not include Medicaid losses or Graduate Medical Education costs. Had the proposed change taken effect, Medicare funding to New York hospitals would have fallen $500 million -- a 50% cut from current levels of uncompensated care payments.

CMS announced yesterday that, "in light of the significant concerns expressed by commenters," they will delay their proposed change and improve S-10 data so that it better reflects the true costs of uncompensated care.

"I commend CMS for modifying its proposal, which would have been devastating to New York's hospitals," Congressman Engel said. "Uncompensated care payments allow our hospitals to provide quality care to patients who have nowhere else to turn. That is why it is essential that those payments reflect the true costs that hospitals face. I applaud CMS for recognizing this, and look forward to working with both CMS and hospital community moving forward."

"Delaying the use of S-10 data and creating a system to improve that data is a major victory for New York's hospital community," said Greater New York Hospital Association (GNYHA) president Kenneth E. Raske. "GNYHA applauds and thanks Congressman Engel and the New York Congressional delegation for their advocacy on this important issue, and for their longtime commitment to improving New York's hospitals."

"Representative Eliot Engel's strong advocacy on behalf of New York's hospitals and health systems was crucial in ensuring that CMS did not move forward with this harmful proposal," said Healthcare Association of New York State (HANYS) president Bea Grause. "HANYS appreciates his leadership and we look forward to continuing our work with Representative Engel and other members of the New York Delegation to protect Medicare DSH funding that hospitals across the state rely on to support services for our most vulnerable populations."

"Congressman Engel and our Senators and Representatives protected us from a misguided policy that would have jeopardized access to healthcare for uninsured and underinsured individuals," said Steven M. Safyer, M.D., President and CEO, Montefiore. "This change protects the services Montefiore provides and allows us to meet our collective moral obligation to care for those most in need. We are grateful to Congressman Engel for his leadership and fierce commitment to preserving accessible healthcare for underserved communities."

"The decision by CMS to modify its proposal ensures that New York's hospitals can continue to care for the most vulnerable patient populations," said Dr. Steven J. Corwin, president and CEO of NewYork-Presbyterian. "I'd like to thank Congressman Engel for his steadfast support of New York's patients and hospitals and the Obama administration for its consideration of our concerns."

CMS' announcement came as part of the final payment rule for the Fiscal Year 2017 Medicare Inpatient Prospective Payment System (IPPS).

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