We’ve seen a lot of interest in our recently proposed Medicaid Fiscal Accountability Rule (MFAR), which is designed to protect the integrity of this critical program and make sure the dollars we spend go to the needs of its 71 million beneficiaries.
Supplemental payments are payments states make to physicians, hospitals, and nursing homes above and beyond the routine reimbursement they receive for services provided to Medicaid beneficiaries.
Supplemental payments can serve an important purpose in Medicaid by providing additional reimbursement to address high need patients or to promote quality and access. This rule doesn’t change that or take this tool away.
Like all Medicaid payments, states have to put up a state match to draw down federal money for a supplemental payment. Federal law places strict limitations on a provider’s ability to donate their own money to use as a state match for Medicaid payments.
But @SenFinance and oversight bodies like @USGAO, @OIGatHHS, & @macpacgov have raised concerns that supplemental payments lack transparency & may circumvent financing rules. They’ve doubled in less than a decade & now account for 17%+ of provider reimbursement.
@SenFinance @USGAO @OIGatHHS @macpacgov For example, some states have found ways around this rule by circumventing provider donation restrictions through by recycling them through a local government like a county so they appear to be legitimate public funds.
@SenFinance @USGAO @OIGatHHS @macpacgov When health care providers find creative ways to put up the state match, it can create a cycle of spending that has little do with value & quality. Some providers end up getting paid much higher than others, distorting the market and leading to unfair competition.
@SenFinance @USGAO @OIGatHHS @macpacgov .@CMSGov’s proposed #Medicaid Fiscal Accountability Rule makes us better able to ensure that Medicaid resources serve the best interests of patients – promoting sustainability to ensure our continued ability to serve future generations. cms.gov/blog/medicaid-…
@SenFinance @USGAO @OIGatHHS @macpacgov @CMSGov MFAR is not intended to reduce #Medicaid payments. In cases where states have financing arrangements that are impermissible, @CMSGov will work w/ them to transition them to an allowable arrangement.
@SenFinance @USGAO @OIGatHHS @macpacgov @CMSGov Nothing about this proposed rule changes who is eligible for Medicaid or what services they receive. The goal of MFAR is to ensure that states are adhering to existing federal statutes & regulations on program financing.
@SenFinance @USGAO @OIGatHHS @macpacgov @CMSGov Nothing in the proposed MFAR would prevent states from using supplemental payments – these options will remain available as long as they are used and financed in a way that follows the law.
@SenFinance @USGAO @OIGatHHS @macpacgov @CMSGov We are now carefully reviewing over 4,000 comments received on the proposed rule, and we greatly appreciate those who provided thoughtful feedback as we consider the best pathway forward for the program and its beneficiaries. cms.gov/blog/medicaid-…
