WHA, along with the American Hospital Association, governors, counties, nursing homes and Medicaid directors across the country, recently urged CMS to withdraw its proposed Medicaid Fiscal Accountability Regulation, which could disrupt Medicaid financing and lead to budgetary concerns for the Medicaid program.
In the proposed rule, the agency said its goal was to cut down on what CMS Administrator Seema Verma has called “shady recycling schemes.” Although CMS indicated the rule was intended to “clarify” policy, the language of the proposal went far beyond, creating new definitions and uncertainty around allowable accounting practices for Medicaid. At its core, CMS gives itself flexibility to evaluate state financing arrangements, which calls into question exactly how the agency would view what have long been considered legitimate financing arrangements.
In its letter from Jan. 31, 2020
, WHA noted the existing partnership among multiple levels of government, health care providers, academic medical centers, and other organizations to safeguard stable funding for the Medicaid program. Even with those efforts, Medicaid generally reimburses providers less than the cost of providing care. As the aim of the Medicaid program has evolved, CMS has allowed states funding flexibility to address state-specific circumstances, which has enabled states to meet the needs of their most vulnerable populations.
“We urge CMS not to view this flexibility negatively, but rather to recognize that this flexibility has strengthened the Medicaid partnerships and the commitment to this critical program, which provides access to health care services to nearly one million people in Wisconsin,” WHA President and CEO Eric Borgerding said.
The proposed rule was open for comment through Feb. 1, 2020. CMS received 3,321 comments. WHA will continue to track developments and the potential implications for Wisconsin’s Medicaid program.