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Fitch: Medicaid Block Grants, MFAR Threaten States, Providers

Medicaid block grants and the proposed Medicaid fiscal accountability regulation (MFAR) pose new financial threats to providers and states, according to Fitch Ratings, the financial rating company. MFAR poses the greater threat, Fitch believes, noting in a new analysis that it could …reduce total Medicaid spending nationally by $37 billion and $44 billion annually…and by $23 billion to $30 billion for hospitals alone.  States, and to some extent providers, would respond to MFAR’s implementation with measures to mitigate the negative fiscal implications. Block grants, through what has been named the Healthy Adult Opportunity program, also pose a threat, with Fitch explaining that Capping federal Medicaid contributions, even for a subset of beneficiaries, poses risks to state budgets and those entities … Read More

Posted in Federal Medicaid issues, Pennsylvania Medicaid, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania

Verma Responds to MFAR Critics

CMS administrator Seema Verma addresses criticism of her agency’s proposed Medicaid fiscal accountability regulation in a new commentary on the CMS blog. Critics of the so-called MFAR regulation have argued that the Centers for Medicare & Medicaid Services’ proposed regulation, if adopted, will lead to a reduction of federal funding for state Medicaid programs, jeopardize access to care and the financial health of providers by leading to a reduction of supplemental payments to high-volume Medicaid providers, and possibly even force some states to raise taxes to compensate for the loss of federal funding. In her commentary Verma rebuts these criticisms, maintaining that the proposed regulation seeks to ensure that states pay their fair share of their Medicaid partnership with the … Read More

Posted in Federal Medicaid issues, Safety-Net Association of Pennsylvania

Verma Responds to Medicaid Block Grant Critics

Last week the Trump administration unveiled its Healthy Adult Opportunity program, a new, optional, already-controversial approach to structuring state Medicaid programs. Ever since, the program – essentially, Medicaid block grants – has been the subject of criticism from many public officials and health care stakeholders. Now, Centers for Medicare & Medicaid Services administrator Seema Verma, who oversaw the development of Healthy Adult Opportunity, has responded to the program’s critics in an op-ed piece published in the Washington Post.  See her commentary “No, the Trump administration is not cutting Medicaid.”

Posted in Federal Medicaid issues

Health Care Groups Rebel Against Proposed Federal Regulation, Program

The administration’s proposed Medicaid fiscal accountability regulation and its guidance encouraging states to implement Medicaid block grants have incurred widespread opposition among a variety of health care groups. The Medicaid fiscal accountability regulation would, if adopted, impose new restrictions on how states raise their share of their Medicaid spending, potentially limiting state participation in Medicaid or necessitating tax increases to fill the funding gap if long-accepted financing tools are no longer available to them. The Medicaid block grant guidance offers states a blueprint for curtailing their Medicaid costs by imposing limits on that spending that they negotiate with the federal government. Numerous health care groups have expressed reservations or direct opposition to one or both of the proposals.  Among them: … Read More

Posted in Federal Medicaid issues, Safety-Net Association of Pennsylvania

PA Says No to Medicaid Block Grants

Pennsylvania is not interested in pursuing the new Medicaid block grants being offered by the administration, leading state officials said last week. In a news release, Governor Wolf said that I expanded Medicaid in Pennsylvania to allow for more than 700,000 people to have reliable health care access. Pennsylvania will not go backwards. I will not risk jeopardizing our progress by going along with another short-sighted, insensitive plan to cut Medicaid… Department of Human Services Secretary Teresa Miller, who oversees the Pennsylvania Medicaid program that serves approximately 2.8 million people, echoed this sentiment: Changing any part of Medicaid to a block grant structure is the federal government permitting states to grow health inequities experienced by the poorest Americans. This cruel … Read More

Posted in Federal Medicaid issues, Pennsylvania Medicaid, Pennsylvania Medicaid policy

SNAP Asks Feds to Withdraw Medicaid Financing Regulation

CMS should withdraw its proposed Medicaid fiscal accountability regulation, SNAP has suggested in a formal comment letter to the federal agency in response to a new regulation it proposed in November. According to the comment letter SNAP submitted to the Centers for Medicare & Medicaid Services, SNAP is concerned that this proposed regulation would inappropriately restrict the state’s ability to finance the non-federal share of the Medicaid program, would impose significant additional regulatory burdens – the cost of which would far outstrip their benefit – would inappropriately introduce subjectivity into the application of previously clear and objective regulatory standards, and is beyond the scope of the statutory authority granted to CMS. Learn more about SNAP’s views on the proposed Medicaid … Read More

Posted in Federal Medicaid issues, Safety-Net Association of Pennsylvania

Supreme Court Lifts Public Charge Rule Ban

The U.S. can now reject visa and green card applicants based on their financial prospects after a new Supreme Court ruling this week. This ruling has potential long-term implications for health care providers. Last August a new Department of Homeland Security regulation took effect that authorized the federal government to reject immigrants’ applications for visas and green cards if their financial situation and employment prospects suggested that they might become a “public charge” and dependent on government safety-net programs like Medicaid and food stamps.  A number of groups sued to prevent the rule’s implementation and federal courts imposed an injunction against its enforcement but now the Supreme Court has lifted the last of these injunctions. The Supreme Court’s ruling, however, … Read More

Posted in Federal Medicaid issues, Pennsylvania safety-net hospitals

Interview With Seema Verma

In late December, PBS broadcast an interview with Centers for Medicare & Medicaid Services administrator Seema Verma.  Kaiser Health News has published a transcript of excerpts from that interview during which Verma discusses Medicaid – including enrollment, eligibility, services, and children – Medicare for all, administration attempts to reduce health care costs, protection for people with pre-existing conditions, and more.  Read those excerpts in the Kaiser Health News article “One-On-One With Trump’s Medicare And Medicaid Chief: Seema Verma.”

Posted in Affordable Care Act, Federal Medicaid issues, Health care reform

Medicaid DSH Cut Delayed

Scheduled cuts in Medicaid DSH payments to hospitals will be delayed until at least late May under new federal spending legislation. The cuts in Medicaid disproportionate share allotments to the states, mandated by the Affordable Care Act and delayed several times by Congress – including twice in FY 2020 alone under continuing resolutions to fund the federal government – are among a number of so-called “extenders” included in spending bills passed by Congress this week and sent to the president for his signature. Authorization for delaying the cut in allotments to the states, which would have resulted in reduced Medicaid DSH payments for many hospitals – including private safety-net hospitals – would expire on May 22.  Congress is expected to … Read More

Posted in Affordable Care Act, DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania Medicaid

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C. The following is MACPAC’s own summary of the sessions. The Medicaid and CHIP Payment and Access Commission kicked off its December meeting with highlights from its forthcoming issue of MACStats: Medicaid and CHIP Data Book, due out December 18, 2019. MACStats brings together statistics on Medicaid and State Children’s Health Insurance Program (CHIP) enrollment and spending, federal matching rates, eligibility levels, and access to care measures, which come from multiple sources. Later the Commission discussed a proposed rule that the Centers for Medicare & Medicaid Services issued in November, which—among other changes—would increase federal oversight of Medicaid supplemental payments. The final morning session … Read More

Posted in DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania safety-net hospitals
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