In its June 2019 report to Congress on Medicaid and CHIP, the Medicaid and CHIP Payment and Access Commission (MACPAC) recommended that Congress modify the Medicaid shortfall portion of the disproportionate share hospital (DSH) limit calculation to exclude costs and payments from third-party payors. This recommendation comes in the midst of numerous legal challenges to a CMS rule that required states to include commercial and Medicare payments in calculating their Medicaid hospital-specific DSH limit. For a breakdown of the relevant issues and the status of the various lawsuits, refer to our comprehensive case chart.
