H.R. 5064: Save our Safety-Net Hospitals Act of 2025

This proposed legislation, titled the "Save our Safety-Net Hospitals Act of 2025," seeks to amend certain provisions of the Social Security Act related to Medicaid payments for hospitals that serve a large number of low-income patients. The bill aims to modify how disproportionate share hospital (DSH) payments are calculated and distributed to these hospitals. DSH payments are funds provided to qualifying hospitals to help cover their costs for treating Medicaid and uninsured patients.

Key Changes Proposed by the Bill

• Adjustment of Payment Limitations: The bill removes existing limits on DSH payments for specific hospitals, thereby allowing more hospitals to qualify for these funds.
• Increased Payment Adjustments: It permits states to use unspent federal funds from previous years to bolster payments to hospitals that have incurred costs exceeding their payments under Medicaid and Medicare programs.
• Consistency Requirements: The legislation ensures that any increased payments must align with the newly amended regulations on DSH payments.
• No Recoupment of Payments: States cannot take back any payments already made to hospitals if those payments were consistent with the rules in effect prior to this bill.
• Retroactive Modifications: States would have the authority to adjust their Medicaid plans retroactively to increase payments, provided these adjustments meet specific criteria.
• Reporting Requirements: If a state increases payments as allowed, it must report those adjustments in its next annual report to the federal government.

Effective Date

The amendments proposed in this bill would take effect for Medicaid State plan rate years starting on or after the date of the bill's enactment. Additionally, it allows states to adjust DSH payments for years where they did not fully utilize their federal allotments prior to the bill's enactment.

Relevant Companies

• HCA Healthcare (HCA): As a significant operator of hospitals, changes to DSH payments could affect HCA's revenue from Medicaid patients relying on their hospitals, particularly in states with high uninsured rates.
• ASGN Incorporated (ASGN): Operating in healthcare staffing, ASGN could be impacted by the demand for healthcare services in safety-net hospitals as payment adjustments may lead to increased patient volumes.
• Tenet Healthcare Corporation (THC): Similar to HCA, Tenet operates hospitals that may receive increased funding under the DSH amendments if they qualify, potentially boosting their financial performance.