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GAO Questions State Medicaid Financing

States are now financing more than a quarter of their share of Medicaid expenditures with money from sources other than state general funds, according to a new study by the Government Accountability Office (GAO).
According to the GAO, 26 percent of state share of Medicaid funding comes from taxes on health care providers, transfers from local governments and local government providers, and other sources.  Such funding, the GAO noted, shifts additional Medicaid costs to the federal government.
Pennsylvania uses such funding mechanisms, including its gross receipts tax on Medicaid managed care organizations and state-wide and Philadelphia hospital assessments.
Exacerbating this problem, the GAO reports, is that the Centers for Medicare & Medicaid Services (CMS), which oversees Medicaid, does not assure that it receives complete and accurate data on funding sources from the states, leaving CMS without a complete understanding of how states are financing their Medicaid expenditures.  In the report, the GAO recommends a stronger CMS effort to gather such data – a recommendation that CMS did not accept.
Learn more about the GAO study “States Increased Reliance on Funds From Health Care Providers and Local Governments Warrants Improved CMS Data Collection” by finding the complete report and a summary here, on the GAO web site.

2014-07-31T06:00:42+00:00July 31st, 2014|Pennsylvania Medicaid policy|Comments Off on GAO Questions State Medicaid Financing

Feds Question PA’s MCO Gross Receipts Tax

The federal government is questioning Pennsylvania’s use of proceeds from its tax on Medicaid managed care organizations to draw down federal Medicaid matching funds.
Federal law permits some use of revenue from health care-related taxes to help finance the state’s share of Medicaid spending, but such taxes must be “broad-based” and a 2009 change in the law narrowed the definition of what constitutes a broad-based tax.
According to an audit performed by the U.S. Department of Health and Human Services’ Office of the Inspector General, Pennsylvania’s current tax on HealthChoices managed care organizations (MCOs)

…is impermissible because it is not broad based (the Gross Receipts Tax does not apply to all MCOs) and because it holds the Medicaid MCOs harmless as taxpayers…

According to the inspector general’s report, the state collected $1.76 billion in gross receipts tax revenue from its Medicaid MCOs between FY 2009 and 2011 and drew down federal Medicaid funds to match that revenue.
State officials disagree with the inspector general’s findings and have submitted their opposing arguments to the federal government.
The loss of gross receipts tax revenue would leave an enormous hole in the state’s financing of its share of Medicaid spending and could pose a considerable challenge for the state’s private safety-net hospitals because they serve so many Medicaid patients.
Find the inspector general’s report, including its findings and recommendations and the state’s response to them, here on the web site of the Office of the Inspector General.

2014-06-03T06:00:47+00:00June 3rd, 2014|Pennsylvania Medicaid policy|Comments Off on Feds Question PA’s MCO Gross Receipts Tax
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