Save our Safety-Net Hospitals Act of 2025
Sponsored By: Representative LaLota
Introduced
Summary
Counts Medicare and other applicable-plan payments in Medicaid Disproportionate Share Hospital (DSH) calculations to strengthen support for safety-net hospitals. It would also let states use certain unspent federal DSH allotments retroactively while adding audit and reporting checks.
Show full summary
- Safety-net hospitals: Could qualify for larger DSH adjustments because payments made under Medicare or other applicable plans can be counted when hospitals show their costs exceeded payments for those patients.
- States: Would be allowed to redistribute unspent DSH allotments for rate years beginning on or after October 1, 2021 and before enactment to increase hospital payment adjustments, subject to a State's DSH allotment cap.
- Oversight and limits: The bill bars recoupment when increases follow the pre-amendment (as of Oct 1, 2021) rules, requires independent audits and lets states retroactively amend plans, with the increased amounts reported in the next annual DSH report.
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 2 benefits, 0 costs, 0 mixed.
Medicare payments count in Medicaid hospital funding
If enacted, hospitals would be able to count some Medicare and certain other plan payments in their Medicaid safety‑net payment math. States could also count some patients whose care was paid first by Medicare or another plan, but only if the hospital’s total costs for those patients were higher than all payments received. These rules would apply to Medicaid rate years that start on or after the bill becomes law.
Use unspent Medicaid hospital support funds
If enacted, states could use unspent federal DSH funds to raise hospital adjustments for rate years that began on or after October 1, 2021 and before this bill becomes law. Any increase would need to follow the DSH rules and stay under the state’s yearly DSH cap. States could ask for retroactive plan changes, but not after the audit due date for that year. If the increase followed the October 1, 2021 rules, states could not take the money back. For future years, the new DSH rules would apply only to rate years that start on or after the bill’s enactment.
Sponsors & CoSponsors
Sponsor
LaLota
NY • R
Cosponsors
Lawler
NY • R
Sponsored 8/29/2025
Mrvan
IN • D
Sponsored 8/29/2025
Clarke (NY)
NY • D
Sponsored 8/29/2025
Matsui
CA • D
Sponsored 10/8/2025
Vindman
VA • D
Sponsored 10/17/2025
Garbarino
NY • R
Sponsored 10/28/2025
Gillen
NY • D
Sponsored 10/31/2025
Tenney
NY • R
Sponsored 12/2/2025
Vasquez
NM • D
Sponsored 12/17/2025
Kim
CA • R
Sponsored 1/13/2026
Roll Call Votes
No roll call votes available for this bill.
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