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Under CMS’s Proposed Medicaid Crackdown, Billions in Payments Hang in the Balance

Posted on Monday, January 13, 2020 12:47 PM

In November 2019, CMS proposed a rule that would rein in spending on Medicaid supplemental payment programs, resulting from concerns about the arrangements that have evolved over time.  This means that States are going to need to take a closer look at their programs, which could be extremely affected in some major states.

“We have seen a proliferation of payment arrangements that mask or circumvent the rules where shady recycling schemes drive up taxpayer costs and pervert the system,” CMS administrator Seema Verma said in a statement announcing the Medicaid Fiscal Accountability Regulation (MFAR).

For fiscal year 2018, nursing facilities (NFs) and intermediate care facilities for people with intellectual disabilities (ICF/IDs) received $50.54 billion in Medicaid fee-for-service payments across the U.S., according to the data.

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