The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule titled “Medicaid Fiscal Accountability Rule.” SDAHO 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
- 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
- Limiting the duration of broad-based or uniform tax waivers to no more than three years, requiring future approvals from the CMS.
- Clarifying how public funds can be used in state financing arrangements.
- Establishing new regulatory definitions for Medicaid “base” and “supplemental”
- Expanded requirements for the disclosure and quantification of Medicaid disproportionate share hospital audit findings