Today, the Centers
for Medicare & Medicaid Services (CMS) issued a notice of proposed
rulemaking (NPRM) to strengthen the fiscal accountability of the Medicaid
program and ensure that state supplemental payments and financing
arrangements are transparent and value-driven. CMS is proposing specific
reporting requirements to assure that the billions of public dollars spent
benefits Medicaid beneficiaries and providers by promoting access to
medically necessary health care services consistent with efficiency,
economy and quality of care. Putting patients first is one of CMS’s top
priorities, and the Medicaid Fiscal Accountability Regulation (CMS-2393-P)
is an important step in that effort.
The Medicaid Fiscal
Accountability Regulation (MFAR) intends to ensure accountability of state
financing, transparency of payments, and the fiscal integrity of the
Medicaid program through numerous clarifications to Medicaid oversight
rules. Specifically, this NPRM proposes to clarify existing financial
policies, many of which have been previously described in sub-regulatory
guidance issued by CMS and through our work with states. More
significantly, the proposed rule would establish new requirements for
states to report provider-level information on Medicaid supplemental
payments, responding to numerous calls from oversight organizations to make
those payments more transparent. Additionally, the proposed rule would
periodically sun-set supplemental payment methodologies and require more
details on the purposes of those payments, allowing CMS and states to
regularly re-evaluate their effects. The rule would also take multiple
steps to eliminate state financing gimmicks that cost the federal
government millions each year.
Through this
regulation, CMS is taking historic steps to increase oversight and improve
fiscal integrity of the Medicaid program and further our goals of
transforming Medicaid by putting patients first, increasing state
flexibility, and ensuring accountability and integrity of the program.
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