“Today, the Trump Administration and the Centers for Medicare & Medicaid Services (CMS) issued a notice of proposed rulemaking to strengthen the fiscal integrity of the Medicaid program and help ensure that state supplemental payments and financing arrangements are transparent and consistent with all applicable statutory requirements…”
“States often make additional payments to providers above the normal reimbursement for billed services. Oversight agencies, including the Government Accountability Office (GAO) and Office of Inspector General (OIG), have recommended changes to better oversee and understand these Medicaid supplemental payments, which have steadily increased from 9.4 percent of all other Medicaid payments in FY 2010 to 17.5 percent in FY 2017. The proposed rule will address several additional areas of program vulnerabilities while clarifying existing financial policies. The proposed rule would establish new requirements for states to report provider-level information on Medicaid supplemental payments, responding to calls from oversight organizations to increase transparency…”
“Many of the vulnerabilities in Medicaid financing arise from high risk financing mechanisms that states have used, or sought to use, to finance the state portion of Medicaid payments… The proposed rule would provide clearer guidance on the law to states and other stakeholders, help close regulatory loopholes, and improve reporting to help CMS ensure that states fund their share of payments to providers through only permissible sources and with methodologies that comport with statutory requirements and align with Medicaid program goals…” Read the full press release here.
Source: Trump Administration Proposes Historic Steps to Strengthen Oversight and Fiscal Integrity of the Medicaid Program – November 12, 2019. CMS.