SAFE Hospitals Act of 2023 State Accountability, Flexibility, and Equity for Hospitals Act of 2023
The bill will fundamentally change how DSH allotments are calculated, transitioning towards a system that considers both state poverty levels and usage rates. By phasing in this new methodology from 2026 to 2035, it aims to enhance the financial sustainability of hospitals that serve disproportionately low-income patients. The legislation also provides states with certain flexibilities, allowing them to permit adjustments to their DSH allotments depending on specific state circumstances, while ensuring that the total DSH funding does not exceed predetermined caps established by the Secretary.
SB407, also known as the State Accountability, Flexibility, and Equity for Hospitals Act of 2023, aims to amend Title XIX of the Social Security Act to establish a new methodology for determining state allotments for Medicaid disproportionate share hospital (DSH) payments. This methodology is based on the poverty levels of each state, ensuring that payments are more equitable and aligned with the needs of low-income populations. The bill underscores the importance of prioritizing DSH payments based on Medicaid inpatient utilization and low-income utilization rates, thereby addressing disparities in hospital funding across different states.
While proponents of SB407 argue that the proposed changes will create a fairer allocation of Medicaid resources and support hospitals that provide essential services to low-income patients, there are points of contention around the potential implications for states with varying levels of poverty. Critics voice concerns that the formula could favor certain states disproportionately, leading to inequities in hospital funding. Additionally, the flexibility granted to states to adjust their allotment may raise questions around accountability and uniformity in healthcare service provision across the nation.