ATLANTA - An attempt by the Department of Community Health to open up a source of federal funding to more hospitals might also lead to cuts in the amount of money some small, rural or local hospitals receive from the program.

The changes are proposed for the Disproportionate Share Hospital program. Under the program, the state distributes a little more than a quarter of a billion dollars in federal money to hospitals to try to make up for low reimbursement rates for Medicaid patients and the uninsured.

Federal law requires hospitals to treat any patient that shows up.

The new guidelines would make about 33 more Georgia hospitals eligible to receive the payments and add $4.8 million to the payment for Atlanta's cash-starved Grady Memorial Hospital, which is believed to be on the brink of financial failure.

Because program funding isn't expected to grow, splitting the money among more hospitals would cost other facilities across the state an average of 3.3 percent to 3.6 percent of what they would otherwise receive in the fiscal year, which ends June 30.

That cut would likely grow in future years because state officials are trying to phase the program in to soften the blow on the small and rural hospitals that are likely to lose substantial portions of their income from the program.

"We were very concerned that they would not have the means to adjust that quickly," said Carie Summers, the department's chief financial officer.

Community Health Commissioner Rhonda Medows said the plan isn't an attempt to save Grady by taking money from other facilities.