States would be permitted to require greater cost-sharing from Medicaid recipients under a new regulation proposed by the federal Centers for Medicare & Medicaid Services (CMS).
The proposed regulation, which also addresses matters involving state Children’s Health Insurance Programs (CHIP) and health insurance exchanges, would permit states to impose increased co-pays for non-emergency use of hospital emergency rooms and for non-preferred prescription drugs.  The cost-sharing for non-emergency use of emergency rooms would be limited to eight dollars for Medicaid recipients with incomes between 100 percent to 150 percent of the federal poverty level but would have no limit for those whose income is beyond 150 percent of the federal poverty level.
Cost-sharing requirements of low-income patients pose a particular challenge for Pennsylvania’s safety-net hospitals.  Many of their Medicaid patients cannot afford larger co-payments and often leave the hospital without paying them, thereby increasing hospitals’ bad debt.
Interested parties have until February 13 to submit comments to CMS about the proposed regulation.
Read a CMS fact sheet on the proposed regulation and find a link to the regulation itself here, on the CMS web site.