Large healthcare industry players are at odds with a proposal from the Trump administration that would change reporting requirements for state supplemental payments to Medicaid providers, according to The Wall Street Journal.
Seven things to know:
1. The Medicaid Fiscal Responsibility Rule, proposed in November 2019, would strengthen federal oversight of how states fund their portion of Medicaid.
2. Under current law, states provide CMS with aggregate payment details for base and supplemental payments to Medicaid providers. The new Medicaid rule would require them to send the federal government provider-level payment details to support the aggregate information.
3. The change could force billions in cuts for hospitals and providers, according to the U.S. Chamber of Commerce. In its comment letter cited by WSJ, the chamber said the rule could reduce Medicaid payments to hospitals and health systems by $23 billion to $31 billion each year.
4. In addition, societies representing medical providers in each state sent a letter to the administration calling for the proposal to be withdrawn.
5. On the state level, governors claim the new rule will put increased pressure on budgets. The National Governors Association said in a recent letter cited by WSJ that the rule could "lead to cuts to states' Medicaid program" and may be an overreach of federal authority.
6. Insurers represented by America's Health Insurance Plans said the change could threaten health insurance coverage among Medicaid beneficiaries and "inhibit access to care for millions of Americans," the organization's CEO, Matt Eyles, told WSJ.
7. CMS has argued the change "will aid with transparency within the Medicaid program as well as support both states and CMS in better oversight of the program." In a recent blog post cited by WSJ, CMS Administrator Seema Verma said the "proposed rule is not intended to reduce Medicaid payments, and alarmist estimates that this rule, if completed, will suddenly remove billions of dollars from the program and threaten beneficiary access are overblown and without credibility."
For a fact sheet on the Medicaid Fiscal Responsibility Rule, click here.