The AHA today commented on Centers for Medicare & Medicaid Services’ approach to implementing the Patient Protection and Affordable Care Act aggregate reductions to state Medicaid Disproportionate Share Hospital allotments. “The proposed rule would not discourage Medicaid expansion, nor would it cause undue harm to hospitals in states that have decided not to expand or in states that have yet to decide to expand their Medicaid programs,” wrote AHA Executive Vice President Rick Pollack. In addition, AHA said the agency’s two-year time frame for the application of the proposed DSH reduction methodology was a “responsible approach,” and expressed general support for its weighting factors and data sources. AHA also urged CMS to engage providers in future changes to its methodology prior to formal rulemaking and be “as transparent as possible on the issues regarding data refinement and methodology improvements.” In the letter, AHA also expressed strong support for the DSH Reduction Relief Act of 2013 (H.R. 1920), which would delay for two years cuts to the Medicare and Medicaid DSH programs to allow more time for health coverage expansions under the ACA to be more fully realized.