HR-5064 : Still Just a Bill

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The "Save our Safety-Net Hospitals Act of 2025" (H.R. 5064) proposes modifications to the Medicaid program regarding disproportionate share hospital (DSH) payment adjustments. These adjustments are intended to support hospitals that serve a large number of low-income patients.

• Changes to DSH Payment Limitations: The bill amends Section 1923(g) of the Social Security Act to modify certain limitations on DSH payments. It broadens the criteria for calculating hospital-specific limits to include payments made under Medicare (Title XVIII) or by applicable health plans.
• Expanded Definition: The bill expands the definition of individuals who qualify for consideration under DSH payment adjustments to include those for whom the state plan or waiver is a payor after Medicare or other applicable plans have been applied, under certain conditions.
• State Option for Unspent Allotments: It allows states to utilize unspent DSH allotments from prior years (starting October 1, 2021) to increase payment adjustments to hospitals, provided that the increased adjustments comply with the modified rules and do not exceed the state's DSH allotment.
• Retroactive Modifications: The bill grants states the authority to retroactively modify their Medicaid state plans or waivers to accommodate these increased payment adjustments, subject to approval by the Secretary and a deadline for submission.
• Reporting Requirements: States that increase payment adjustments under this provision must include information on these adjustments in their annual reports.

In essence, H.R. 5064 aims to provide greater flexibility and support to safety-net hospitals through adjustments to DSH payment rules under Medicaid.

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