The "Save Our Safety-Net Hospitals Act of 2025" seeks to modify certain limitations on Disproportionate Share Hospital (DSH) payment adjustments under the Medicaid program. It amends the Social Security Act to revise how a hospital's DSH limit, based on uncompensated care costs, is calculated. The bill standardizes the inclusion of payments from Medicare (Title XVIII) and applicable private plans when determining the payments received for services, which are then subtracted from a hospital's costs. This change removes a prior exception for hospitals with high Medicaid inpatient utilization rates. The legislation also expands the definition of individuals whose uncompensated care costs can be counted towards the DSH limit. This now includes patients eligible for Medicaid who also have Medicare or private insurance, provided the hospital's incurred costs exceed all payments received for their services. A significant provision allows states to retroactively distribute unspent Federal DSH allotments from State plan rate years beginning on or after October 1, 2021, and before the bill's enactment. These unspent funds can be used to increase payments to hospitals, provided the adjustments align with the newly modified DSH limit calculations, and states may retroactively modify their State plans to facilitate these increases.