In recent years, the State legislature has increasingly under-funded Medicaid inpatient hospital rates in order to balance the budget. As of November 2010, the State will fall short by 39% in paying inpatient hospital cost (includes 38% cap plus 1% legislative reduction effective 10/1/10).
During fiscal year 2009, Medicaid Disproportionate Share Hospital (DSH) payments and Medicaid Upper Payment Limit (UPL) payments approximated $3.2 billion. The Medicaid DSH and UPL payments that are provided to local public and private hospitals are made possible through the use of local tax funds transferred to the state in order to claim federal matching funds. In other words, local funds are used to claim federal funds in lieu of state general revenue.
HHS has proposed expansion of Medicaid Managed Care to include hospital services currently carved out of managed care in North Texas. Under federal guidelines, it is important that hospital services remain carved out of managed care to preserve federal matching funds for UPL payments. On a statewide basis the proposal is projected to generate biennial savings of approximately $110.6 million through an HMO tax levy and $304.3 million in general revenue savings. However, the proposal puts at risk approximately $4.6 billion in biennial UPL payments statewide. Hospitals in the Dallas-Fort Worth metroplex account for over $700 million of these UPL payments at risk.
Request
- Support the preservation of Medicaid Inpatient Hospital Managed Care Carve Out currently in place in North Texas
- Support proposals to preserve and secure full federal Medicaid match
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About Baylor Scott & White Health
As the largest not-for-profit health system in the state of Texas, Baylor Scott & White promotes the health and well-being of every individual, family and community it serves. It is committed to making quality care more accessible, convenient and affordable through its integrated delivery network, which includes the Baylor Scott & White Health Plan, Baylor Scott & White Research Institute, the Baylor Scott & White Quality Alliance and its leading digital health platform – MyBSWHealth. Through 51 hospitals and more than 1,200 access points, including flagship academic medical centers in Dallas, Fort Worth and Temple, the system offers the full continuum of care, from primary to award-winning specialty care. Founded as a Christian ministry of healing more than a century ago, Baylor Scott & White today serves more than three million Texans. For more information, visit: BSWHealth.com