ATLANTA -- Recent changes in federal Medicaid reimbursements to Alabama will fiscally strain hospitals in the state, possibly leading to downgrades, a Moody's Investors Service analyst said last week.

The assessment came after the federal government, beginning Oct. 1, began phasing out its "disproportionate share" Medicaid payment program to states whose hospitals treat a large share of poor citizens. Like other states participating in the program, Alabama had received the supplemental payments, which were then passed on to both private and public hospitals treating indigent patients.

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