Senate BBB Draft Scraps Medicaid DSH Cuts, Nursing Home Staff Requirements


December 12, 2021 3:05 pm

The Senate Finance Committee on Saturday (Dec. 11) unveiled a tweaked version of the Build Back Better plan that eliminates the House proposal to cut Medicaid Disproportionate Share Hospital payments in non-Medicaid expansion states and the House provision that would require minimum nursing home staffing, addressing concerns by hospitals and nursing homes.

The Finance Committee’s draft version also would create an $800 million grant to support improved staffing in certain long-term care facilities.

While House and Senate Democrats’ reached a reconciliation deal to close the Medicaid gap in states that haven’t expanded the program, hospitals criticized a House provision[/node/125209] to cut Medicaid DSH pay and uncompensated care pools in states where those in the Medicaid gap could get coverage through the marketplace under the gap fix policy.

And nursing homes criticized the House bill’s nursing home staff requirements. The American Health Care Association asked Congress on Nov. 19 to remove the House BBB provisions that require nursing homes have a minimum staffing ratio and registered nurses available 24 hours a day. The Senate draft unveiled Saturday does not include this requirement, but it keeps the $50 million allocation for HHS to study within three years, and every five years after that, the appropriate minimum staffing ratios for nursing homes.

However, Medicare beneficiary advocates have been pushing to keep the minimum staffing requirements, arguing quality of care and outcomes improve with better staffing.