“On November 18, 2019, the Centers for Medicare & Medicaid Services (CMS) proposed changes to federal Medicaid rules that, if implemented, would affect billions of dollars of Medicaid payments nationwide, creating new uncertainty for state budgets and for Medicaid providers. The proposed rulemaking, entitled the Medicaid Financing and Accountability Regulation or MFAR, would broadly expand federal oversight over Medicaid supplemental payments and rewrite key rules governing how those payments are structured, financed, and distributed. In a press release announcing the MFAR, CMS called the rulemaking an effort to ‘strengthen the fiscal accountability of the Medicaid program and ensure that state supplemental payments and financing arrangements are transparent and value-driven.’”
- New Scrutiny of Supplemental Payments
- Restrictions on Using Local Funds as the Non-Federal Share
- Changes to Provider Taxes
- New Authority to Prevent Non-Bona Fide Provider-Related Donations
- Additional Requirements for Publicly-Owned, Privately-Operated Facilities
- DSH Payments
- Retention Requirements and State Administrative Fees
Next Steps
“If implemented, the MFAR would usher in a new era of enhanced federal scrutiny over Medicaid payment methodologies. These changes are certain to draw opposition from state Medicaid agencies and governors as well as from Medicaid providers, as any withdrawal of federal funds will have significant financial impact on state budgeting. Stakeholders’ comments may be submitted on the MFAR until January 17, 2020. Stakeholders should also anticipate potential legal and political efforts to prevent the implementation of the MFAR…” Read the full article here.
Source: CMS Proposes Enhanced Scrutiny over Medicaid Supplemental Payments – By Anil Shankar, Diane Ung, and Adam J. Hepworth, November 20, 2019. Foley & Lardner LLP.
