On Tuesday, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule titled “Medicaid Fiscal Accountability Rule.” CHA is still analyzing the provisions outlined in the proposed rule and the potential impact of new guidelines and reporting for Medicaid supplemental payments and their financing arrangements.
While the administration continues to make transparency in all government programs a priority, CMS is under no statutory timeline to finalize this rule, so the timing of release of a final rule and effective dates are unclear at this time.
The proposed rule includes:
- Provider-level reporting of supplemental payments, including the source of non-federal share
- A time limitation of not longer than three years for State Plan Amendments implementing supplemental payments
- Changes to the permissibility of using intergovernmental transfers for supplemental payments — specifically, limiting public funds used as sources of non-federal share to local or state tax revenues
- Additional standards for health care-related taxes
- Expanded requirements for the disclosure and quantification of Medicaid disproportionate share hospital audit findings
CHA will provide a detailed summary of the proposed rule, including its impact on California’s hospitals, in the coming weeks. CHA looks forward to engaging members, the Department of Health Care Services, and our state and national hospital association colleagues as we develop a comprehensive response and advocacy strategy. Additional details about CHA’s next steps, and what hospitals can do to make sure their voices are heard, will be shared in the near future.