CEO Message

CMS Proposal Could Challenge Medicaid Nationwide

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A proposal released last week by the Centers for Medicare & Medicaid Services (CMS) holds the potential to impact Medicaid programs in every state — one of the main reasons it’s likely to cause Medicaid agencies across the country to share their concerns with CMS.

The Medicaid Fiscal Accountability Rule could alter how Medicaid supplemental payments and related financing arrangements operate. If adjustments to current rules are made, hospital resources for patient care throughout the nation would be challenged.

While any changes to the Medicaid supplemental payments could affect California’s hospitals, it’s important to note that at this time, the proposal is quite far from becoming policy. There are multiple measures that your association, working alongside our colleagues in 49 other states and the District of Columbia, as well as the American Hospital Association (AHA), will take to protect critical Medi-Cal funds for your patients and communities.

First, we’ll be analyzing the rule and its potential impact on California.

Second, we’ll develop messages to deliver to CMS during the current 60-day comment period. Stay tuned for a request for help with this effort — we may need to ask hospital leaders to raise your voice as well, so federal regulators understand how these changes might impact the patients and communities you serve.

Finally, we’ll coordinate with other state hospital associations and the AHA on a national advocacy strategy. This rule will present challenges for dozens of governors, regardless of political party. That likely means a long and public debate about the very real dangers of the rule, where hospitals will have another chance to make clear that the proposal will do nothing to make Medicaid more fiscally accountable and will harm the low-income patients we serve.

The bottom line: this proposal could be bad news. But it’s got a long way to go, and its potential impact is so far-sweeping that there will be massive opposition to modify or defeat it altogether.

For now, we need to better understand the impact, relay our concerns to CMS, and work with our national colleagues on a sound strategy to ensure the resources you need to care for patients aren’t altered — especially as costs continue to rise.

— Carmela