MO HealthNet Releases Guidance On Uncompensated Care Costs, DSH Payment Changes

The Missouri Department of Social Services’ MO HealthNet Division provided notice to the Missouri Hospital Association regarding MHD’s interpretation of the Consolidated Appropriations Act of 2026, which was enacted Feb. 3.

According to MHD, beginning with state fiscal year 2024, uncompensated care costs will be calculated based on the most favorable option of:

• Medicaid primary and uninsured or

• Medicaid primary, Medicaid duals (Title 18 and applicable plans primary) and uninsured

For those hospitals who qualify for the 97th percentile exception, the calculation for SFY 2024 can consider the best outcome among:

• Medicaid primary and uninsured

• Medicaid primary, Medicaid duals (Title 18 and applicable plans primary) and uninsured or

• All Medicaid eligibles and uninsured

No hospital will face a penalty under the new UCC methodology as overpayments cannot increase. However, some overpaid hospitals may benefit by seeing a reduction in their overpayment amounts. 

This change may reduce potential Disproportionate Share Hospital liabilities and allow hospitals to release reserves as part of SFY 2026 year-end calculations.

An MHD bulletin containing this information will be shared with membership as soon as it becomes available.