Senators Reverend Warnock and Ossoff pressured Senate leadership to allow Georgia’s 51 Medicare Disproportionate Share Hospitals (DSH) to maintain their status for two years as the state’s health care system stabilizes

Disproportionate Share Hospitals serve large numbers of low-income patients and receive support through federal programs to help cover the cost of caring for uninsured patients

23 of these 51 hospitals are at risk of losing this status, and consequently at risk of closing, because of Medicaid redeterminations and a backlog with Social Security Insurance disability claims, undermining Georgia facilities’ cost reports that determine DSH eligibility

Senators Reverend Warnock, Ossoff: “Georgia has the most hospitals in the country in jeopardy of losing status. If these hospitals no longer qualify, we are deeply concerned about their ability to continue to operate”

ICYMI from the Macon Telegraph: These 2 Bibb County hospitals are in danger of losing their government funding. Here’s why

Washington, D.C. – Today, U.S. Senators Reverend Raphael Warnock (D-GA) and Jon Ossoff (D-GA) pressured Senate leadership to allow Georgia’s 51 Medicare Disproportionate Share Hospitals (DSH) to maintain their status for two years as the state’s health care system stabilizes. Disproportionate Share Hospitals serve larger numbers of low-income patientsand receive support through federal programs to help cover the cost of caring for uninsured patients. 23 of these 51 hospitals are at risk of losing this status, and consequently at risk of closing, because of Medicaid redeterminations and the backlog with Social Security Insurance disability claims.

According to the Georgia Hospital Association (GHA), three of Georgia’s largest DSH facilities estimated more than $150 million in unpaid claims due to the backlog of Social Security Administration applications. This amounts to more than 1,600 patients who cannot be counted in these facilities’ cost reports for federal DSH formula calculations, jeopardizing their access to federal programs and, subsequently, their ability to operate. 

“Since May 2023, more than 380,000 Medicaid patients have been terminated from Georgia’s Medicaid program, and additional patients will continue to lose coverage until the reenrollment process is complete.  Patient applications for benefits through the Social Security Administration (SSA) are also significantly delayed at the state level,” said Senators Reverend Warnock, Ossoff.“According to the Georgia Hospital Association (GHA), three of Georgia’s largest DSH facilities estimated more than $150 million in unpaid claims due to the backlog of Social Security Administration applications. This amounts to more than 1,600 patients who cannot be counted in these facilities’ cost reports for federal DSH formula calculations. Georgia’s hospitals have never been more at risk than they are today… Compounded by Georgia’s refusal to expand Medicaid, with 23 hospitals at risk of losing such eligibility, Georgia has the most hospitals in the country in jeopardy of losing status. If these hospitals no longer qualify, we are deeply concerned about their ability to continue to operate.”

Senator Reverend Warnock has long championed efforts to expand affordable health care access, starting with his advocacy to close the health care coverage gap in Georgia. Last year, the Senator led a delegation of Georgia lawmakers in urging the Centers for Medicaid and Medicare Services(CMS) to provide tools to Medicaid non-expansion states like Georgia to help them protect health care access for Medicaid enrollees who lose eligibility after the public health emergency declaration ends. In February, Senator Warnock urged the Center for Medicaid and Medicare Services (CMS) to ensure that the gains made in reducing the number of uninsured children are not lost as states begin to unwind some Medicaid policies that have been in place since the start of the COVID-19 public health emergency. In September, the Senator urged the Biden Administration to leverage every resource possible to keep Georgians, especially children, covered by Medicaid if they are eligible during the Medicaid unwinding process.

Find the full text of the letter below: 

Dear Senators Murray, Collins, Sanders, and Cassidy, 

We write to request that you include in the Fiscal Year 2024 Labor, Health and Human Services, Education, and Related Agencies Appropriations bill a provision to allow flexibility for current Medicare Disproportionate Share Hospitals (DSH) to maintain their DSH status for two years as the nation’s health care system continues to stabilize.

We appreciate your past efforts to provide stability for our nation’s hospitals, especially during and following the pandemic. However, the lingering instability in our health care system continues to present challenges as hospitals attempt to recover. Of particular concern are two pandemic-related challenges affecting DSH calculations for Georgia hospitals: Medicaid redeterminations and the backlog with Social Security Insurance disability claims. As a result, Georgia’s disproportionate share hospitals require flexibility in determining eligibility for federal programs for two years to prevent catastrophic and existential financial losses that could threaten their ability to operate.   

Since May 2023, more than 380,000 Medicaid patients have been terminated from Georgia’s Medicaid program, and additional patients will continue to lose coverage until the reenrollment process is complete.[1] Patient applications for benefits through the Social Security Administration (SSA) are also significantly delayed at the state level.[2] According to the Georgia Hospital Association (GHA), three of Georgia’s largest DSH facilities estimated more than $150 million in unpaid claims due to the backlog of Social Security Administration applications. This amounts to more than 1,600 patients who cannot be counted in these facilities’ cost reports for federal DSH formula calculations.

Georgia’s hospitals have never been more at risk than they are today. Fifty-one Georgia hospitals have DSH status, and GHA estimates that 23 of those facilities are at risk of losing eligibility for at least one federal program. Compounded by Georgia’s refusal to expand Medicaid, with 23 hospitals at risk of losing such eligibility, Georgia has the most hospitals in the country in jeopardy of losing status. If these hospitals no longer qualify, we are deeply concerned about their ability to continue to operate.  

Congress has a responsibility to prevent state and federal policies and bureaucratic inefficiencies from unfairly harming struggling hospitals and low-income patients. Because of these challenges, we request a temporary renewal of the eligibility waiver Congress enacted via Section 121 of the Consolidated Appropriations Act of 2022 for DSH entities for two additional years.[3] This temporary renewal would allow the SSA to catch up on applications and enable Medicaid patients who were dropped from the program to be re-enrolled without jeopardizing the vital community benefit programs that DSH entities provide.  

Penalizing DSH entities for administrative backlogs and procedural challenges at both the state and federal government agencies will jeopardize their ability to continue to serve the community, and Georgia patients will pay the price. We appreciate your prompt attention to this urgent matter facing Georgia hospitals.  

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