Even as the House Energy and Commerce Committee contemplates how it will reach its assigned target of $880 billion in spending cuts mostly through Medicaid cuts, the Centers for Medicare & Medicaid Services may be following a similar course by targeting two potential changes that Congress is already thought to be considering: changes in policies governing Medicaid provider taxes and state-directed Medicaid payments.
Recently, CMS filed a proposed regulation titled “Preserving Medicaid Funding for Vulnerable Populations – Closing a Health Care-Related Tax Loophole” to the Office of Management and Budget (OMB) for review.
Speculation centers on whether this proposed policy could mean changes in how CMS reviews state proposals to tax providers – a tool used for raising part of states’ share of their Medicaid programs’ costs currently employed in 49 of the 50 states.
Another possibility: that the proposed policy could be intended to tighten restrictions on state-directed Medicaid payments, which growing numbers of states are using to require the managed care plans that serve their Medicaid population to make supplemental payments for the delivery of selected high-cost, low-reimbursement services as a way of ensuring continued access to those services.
The next step will be for OMB to review the proposed regulation, which would – in theory – pave the way for CMS to publish and officially propose it.
Find CMS’s filing of the proposed regulation with OMB here and learn more about the proposed regulation, its status, and its possible meaning from the Healthcare Dive article “CMS may be angling to reform Medicaid state directed payments.”