Medicaid regulations

CMS Proposes Medicaid Provider Tax Regulation

The Centers for Medicare & Medicaid Services has published a proposed rule that would implement a portion of H.R. 1, last year’s federal budget reconciliation bill, that called for establishing new indirect hold-harmless thresholds for health care-related taxes – primarily, provider taxes, which are currently employed in 49 states and the District of Columbia. Major changes include: Replacing the six percent safe harbor with state-specific thresholds based on July 4, 2025 structures. Prohibiting states from introducing new Medicaid provider taxes or increasing existing provider taxes that were in effect on that same date. Phasing down the provider tax ceiling [...]

joe2026-07-23T16:11:10-04:00July 24, 2026|Medicaid, Medicaid managed care, Medicaid regulations|

Federal Health Policy Update for July 23

Don’t Miss: Congress advances health care bills CMS proposes provider tax rule Courts act on ACA changes, 340B The following is the latest health policy news from the federal government for July 17-23. Some of the language used below is taken directly from government documents. Congress The House Energy and Commerce Committee held a markup for 29 bills, advancing the following health care transparency measures with bipartisan support: H.R. 9390, Prices on the Wall Act of 2026 H.R. 9393, Lower Costs, More Transparency Act of 2026, part of a package that also includes: H.R. 3514, Improving Seniors’ Timely Access [...]

joe2026-07-23T16:29:15-04:00July 23, 2026|340b, Affordable Care Act, MACPAC, Medicaid managed care, Medicaid regulations, Medicare regulations, Medicare reimbursement policy, MedPAC|

States, Hospitals, Patients Brace for Big Beautiful Bill Effects

The effects of last year’s One Big Beautiful Bill Act will soon be felt by states, providers, and consumers and some of them are already preparing for the impact. States face an expected loss of $664 billion in Medicaid money over the next eight years as a result of 12 provisions in the 2025 law. The major causes: Medicaid work requirements that will reduce eligibility, more frequent eligibility redeterminations, and tougher limits on revenue-generating Medicaid provider taxes and Medicaid managed care state-directed payments. Some states will lose more than others. The biggest losers, by percentage, will be Arizona, Iowa, and [...]

joe2026-03-03T16:52:49-05:00March 4, 2026|hospitals, Medicaid, Medicaid managed care, Medicaid regulations|

Are Medicaid Provider Taxes, State-Directed Payments in Play?

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 [...]

joe2025-04-24T15:54:20-04:00April 28, 2025|Centers for Medicare & Medicaid Services, hospitals, Medicaid, Medicaid managed care, Medicaid regulations|

Federal Health Policy Update for July 12

The following is the latest health policy news from the federal government for July 6-12. Some of the language used below is taken directly from government documents. The Courts A federal court has blocked implementation of the FTC’s rule banning non-compete clauses in most employment contracts, a regulatory development with potentially significant implications for the health care industry. The temporary ban affects only the five plaintiffs in the case and it is not yet clear whether the ruling will have broader implications in the wake of the recent reversal of the Chevron decision that could potentially curtail the rulemaking authority [...]

joe2024-07-12T18:46:49-04:00July 12, 2024|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, health equity, hospitals, Medicaid, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for February 22

The following is the latest health policy news from the federal government for February 16-22. Some of the language used below is taken directly from government documents. CMS and Medicaid DSH Payments CMS has published a final rule governing how third-party payers are factored into the calculation of hospitals’ Medicaid disproportionate share hospital-specific payment limit. This change requires that the calculation be based solely on Medicaid costs and payments and that costs and payments associated with dually eligible (Medicare and Medicaid) patients be excluded from the calculation of that limit. The effect of this change is that hospitals that are [...]

joe2024-02-22T22:00:03-05:00February 22, 2024|Alternative payment models, Centers for Medicare & Medicaid Services, COVID-19, health equity, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid regulations, Medicaid upper-payment limit, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

Feds Tackles State Medicaid Redetermination Problems With Penalties

The Centers for Medicare & Medicaid Services has unveiled plans to penalize states that fail to comply with federal standards for redetermining the eligibility of individuals who enrolled in their Medicaid programs during the COVID-19 emergency. Under a new CMS regulation, states that fail to report on their Medicaid eligibility efforts and comply with current requirements face penalties that include civil penalties and reductions in the rate at which the federal government matches state Medicaid expenditures. According to a new interim final rule, CMS is implementing … reporting requirements and enforcement authorities in the Social Security Act (the Act) that [...]

joe2023-12-05T16:30:03-05:00December 6, 2023|COVID-19, Medicaid|

Federal Health Policy Update for May 4

The following is the latest health policy news from the federal government for April 28 – May 4. Some of the language used below is taken directly from government documents. End of the COVID-19 Public Health Emergency DeBrunner & Associates has prepared a summary of the status of selected government health care waivers and flexibilities upon the expiration of the COVID-19 public health emergency on May 11. The DeBrunner summary covers telehealth, COVID-19 treatment and coverage, flexible hospital operations, long-term-care hospitals, inpatient rehabilitation facilities and units, patient cost-sharing, and state Medicaid waivers. Find the summary here. The COVID-19 public health [...]

iqtsupport2023-05-04T17:25:59-04:00May 4, 2023|Centers for Medicare & Medicaid Services, COVID-19, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicaid regulations, Medicare, Medicare reimbursement policy, Telehealth|

Coronavirus Update for Friday, January 29

The following is the latest COVID-19 information from the federal government as of 2:30 p.m. on Friday, January 29. The Biden Administration The Biden administration has issued an “Executive Order on Strengthening Medicaid and the Affordable Care Act” to make it easier for the uninsured to get coverage during the COVID-19 pandemic. The order: reopens access to the federal Affordable Care Act health insurance marketplace for three months, from February 15 through May 15, and restores some of the Affordable Care Act exchange marketing funds that had been eliminated by the previous administration and calls for the review of all [...]

iqtsupport2021-02-01T06:00:16-05:00February 1, 2021|Affordable Care Act, Coronavirus, COVID-19, Medicaid|

MFAR Backlash Continues

Diverse health care and government interests are rallying around their opposition to the proposed Medicaid fiscal accountability rule. The regulation, proposed by the Centers for Medicare & Medicaid Services in November, would impose new limits on the ability of states to finance their share of their Medicaid spending, potentially jeopardizing provider payments and the ability of high-volume Medicaid providers to operate without suffering great losses. In all, CMS received more than 4200 written comments in response to the proposed regulation, most of them expressing opposition. Among those doing so were state governments, the National Governors Association, hospitals and hospital associations, [...]

iqtsupport2020-03-02T06:00:22-05:00March 2, 2020|Medicaid, Medicaid DSH, Medicaid regulations|