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Federal Lawmakers Discuss DSH Payments, Amended Transparency Bill

May 17, 2023

The House Energy and Commerce Health Subcommittee advanced legislation today that would delay harmful cuts to the Medicare Disproportionate Share Hospital program (DSH) and would include a host of other measures related to the cost of care.

During a meeting today, the subcommittee advanced the Transparent PRICE Act. The legislation, sponsored by Representative Cathy McMorris Rodgers (R-WA), has several new amendments relevant to hospitals and health systems, including:

  • Delaying DSH cuts:  The legislation would delay $8 billion in annual cuts to the DSH program until fiscal year 2026 as outlined in the Supporting Safety Net Hospitals Act.
    • Under CMS’s 2019 DSH reform reduction plan, Pennsylvania’s federal Medicaid DSH allotment would be reduced by 67.1 percent, from $759 million to $250 million during FY 2024.
  • Outpatient drug costs:  A new amendment would require Medicare to pay the same rates for physician-administered drugs in off-campus hospital outpatient departments as beneficiaries and Medicare do in physician offices.
  • Outpatient billing:  The act includes a proposal co-sponsored by Representative John Joyce (R-PA-13) that would require each off-campus outpatient department of a provider to obtain and include a national provider identifier on billings for claims for services.
  • Ownership reporting:  The act would require hospitals, freestanding emergency centers, ambulatory surgical centers, physician practices with more than 25 physicians, and physician practices to report ownership information and changes in ownership to the federal government.
  • Transparency measures:  The legislation includes a few notable transparency measures, requiring hospitals to make all standard charges public through machine-readable files and extending certain price transparency requirements to diagnostic labs, among other measures.

Additionally, lawmakers narrowly advanced separate legislation that seeks to bolster transparency and oversight of the 340B Drug Pricing Program. The legislation goes to the full committee for review.

In a letter earlier this week, a bipartisan coalition of lawmakers urged action to avert pending cuts to the DSH program that are set to take effect on October 1. HAP continues to monitor the latest legislative activity in Washington and advocate for the resources hospitals need to remain anchors within their communities.

For more information, contact John Myers, HAP’s vice president, federal advocacy.