Committee hears debate over hospital supplemental-payment changes that carve out funds for small, unaffiliated critical-access hospitals and quality incentives

Representative Gillette, sponsor of House Bill 9 36’s policy companion, told the committee the bill includes two new carve-outs in the state’s inpatient supplemental payment distribution that aim to help the smallest, most at‑risk hospitals and to reward quality. She said the packet of changes comes from the Appropriations Committee and is intended to relieve pressure on systems that provide rural access to care.

The two contested provisions described in committee testimony were: an additional 2 percentage-point carve‑out of the inpatient supplemental payment (frequently called the “bed tax”) to be redistributed to independent, non‑affiliated critical‑access hospitals, and a separate 2 percentage‑point carve‑out to be redistributed to all hospitals as quality incentive payments. Representative Gillette said the measures represent modest redistributions — roughly $4 million each from a roughly $200 million pool — aimed at bolstering fragile facilities and incentivizing better outcomes.

Duane Preshinger of the Montana Hospital…