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The statute defines participating hospitals as those that accept payment from the Department of Health and Human Services', Centers for Medicare and Medicaid Services (CMS) under the Medicare program. [2] Because there are very few hospitals that do not accept Medicare, the law applies to nearly all hospitals.
The introduction of Medicaid and Medicare had helped hospitals shoulder the burden of providing care to poverty-level and elderly patients, but the many people in the United States without health insurance were still vulnerable to inappropriate patient transfer or dumping. [5]
The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards.
The Sunshine Act requires manufacturers of drugs, medical devices, biological and medical supplies covered by the three federal health care programs Medicare, Medicaid, and State Children's Health Insurance Program (SCHIP) to collect and track all financial relationships with physicians and teaching hospitals and to report these data to the Centers for Medicare and Medicaid Services (CMS).
Hospital readmission rates were formally included in reimbursement decisions for the Centers for Medicare and Medicaid Services (CMS) as part of the Patient Protection and Affordable Care Act (ACA) of 2010, which penalizes health systems with higher than expected readmission rates through the Hospital Readmission Reduction Program.
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The Patient Protection and Affordable Care Act (PPCA) aims to reduce: . Funding for the Medicaid DSH program by $17.1 billion between 2014 and 2020; [3] Aggregate Medicaid DSH allotments by $0.5 billion in 2014, $0.6 billion in 2015, $0.6 billion in 2016, $1.8 billion in 2017, $5 billion in 2018, $5.6 billion in 2019, and $4 billion in 2020; and