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MFAR Backlash Continues

Diverse health care and government interests are rallying around their opposition to the proposed Medicaid fiscal accountability rule.

Bookshelf with law booksThe 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, nursing home operators, and health advocacy organizations.  Also among them was the Safety-Net Association of Pennsylvania.  In summarizing its opposition, SNAP wrote in a formal comment letter to CMS on behalf of Pennsylvania safety-net hospitals that

SNAP is concerned that this proposed regulation would inappropriately restrict the state’s ability to finance the non-federal share of the Medicaid program, would impose significant additional regulatory burdens – the cost of which would far outstrip their benefit – would inappropriately introduce subjectivity into the application of previously clear and objective regulatory standards, and is beyond the scope of the statutory authority granted to CMS.

See SNAP’s entire letter here.

Learn more about the Medicaid fiscal accountability rule, what it seeks to do, and why so many oppose in the Stateline article “Medical Groups Slam Trump Medicaid Rule.”

 

2020-03-04T06:00:15+00:00March 4th, 2020|Federal Medicaid issues, Medicaid supplemental payments|Comments Off on MFAR Backlash Continues

SNAP Rallies PA Delegation to Oppose MFAR

A proposed federal Medicaid regulation could limit Pennsylvania’s ability to finance its Medicaid program and jeopardize supplemental payments to the state’s private safety-net hospitals, so SNAP has asked members of the state’s congressional delegation to sign a letter to CMS Administrator Seema Verma asking her to reconsider the potentially damaging Medicaid fiscal accountability regulation.

Safety-Net Association of Pennsylvania logoIn its letter to members of the state’s congressional delegation, SNAP wrote on behalf of private Pennsylvania safety-net hospitals that

The proposed Medicaid fiscal accountability regulation (MFAR) would, if implemented, impose new limits on how states may raise their share of funds to support their Medicaid programs. If adopted, the commonwealth would face a serious challenge raising the money it needs to finance its share of the cost of its Medicaid program. In addition, MFAR would take a great deal of states’ Medicaid policy-making authority away from state governments and give it instead to the federal Department of Health and Human Services.

Two members of the state’s congressional delegation, Representatives Brendan Boyle (D-Montgomery/Philadelphia) and Mike Kelly (R-Butler/Crawford/Erie/Lawrence/Mercer), have written a bipartisan letter to be sent to CMS Administrator Seema Verma asking her to reconsider the troubling aspects of MFAR.  SNAP wrote to members of the state’s congressional delegation asking them to sign onto the letter.

Go here to see the full SNAP letter to the delegation.

 

2020-03-03T06:00:10+00:00March 3rd, 2020|Federal Medicaid issues, Pennsylvania Medicaid policy, Uncategorized|Comments Off on SNAP Rallies PA Delegation to Oppose MFAR

Fitch: Medicaid Block Grants, MFAR Threaten States, Providers

Medicaid block grants and the proposed Medicaid fiscal accountability regulation (MFAR) pose new financial threats to providers and states, according to Fitch Ratings, the financial rating company.

MFAR poses the greater threat, Fitch believes, noting in a new analysis that it could

…reduce total Medicaid spending nationally by $37 billion and $44 billion annually…and by $23 billion to $30 billion for hospitals alone.  States, and to some extent providers, would respond to MFAR’s implementation with measures to mitigate the negative fiscal implications.

Bookshelf with law booksBlock grants, through what has been named the Healthy Adult Opportunity program, also pose a threat, with Fitch explaining that

Capping federal Medicaid contributions, even for a subset of beneficiaries, poses risks to state budgets and those entities reliant on state funding, including local governments and providers.  States would need to find revenue or cost savings, either in Medicaid or elsewhere, to offset reduced federal contributions.

Because Pennsylvania safety-net hospitals care for more Medicaid patients than the typical hospital, both proposed policy changes have a potentially greater impact on them.

Last month SNAP conveyed its opposition to the proposed MFAR regulation in a formal comment letter to the Centers for Medicare & Medicaid Services in response to the regulation’s publication late last year.  Pennsylvania Governor Tom Wolf has already rejected the idea of using block grants in the state’s Medicaid program.

Learn more about the potential impact of the proposed Medicaid fiscal accountability regulation and Medicaid block grants in the Fitch Ratings analysis “Fitch Rtgs: Medicaid Changes Will Affect States, NFP Healthcare Providers.”

2020-02-20T06:00:08+00:00February 20th, 2020|Federal Medicaid issues, Pennsylvania Medicaid, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off on Fitch: Medicaid Block Grants, MFAR Threaten States, Providers

SNAP Asks Feds to Withdraw Medicaid Financing Regulation

CMS should withdraw its proposed Medicaid fiscal accountability regulation, SNAP has suggested in a formal comment letter to the federal agency in response to a new regulation it proposed in November.

Safety-Net Association of Pennsylvania logoAccording to the comment letter SNAP submitted to the Centers for Medicare & Medicaid Services,

SNAP is concerned that this proposed regulation would inappropriately restrict the state’s ability to finance the non-federal share of the Medicaid program, would impose significant additional regulatory burdens – the cost of which would far outstrip their benefit – would inappropriately introduce subjectivity into the application of previously clear and objective regulatory standards, and is beyond the scope of the statutory authority granted to CMS.

Learn more about SNAP’s views on the proposed Medicaid fiscal accountability regulation and why SNAP believes CMS should withdraw it in SNAP’s formal comment letter.

2020-02-03T06:00:47+00:00February 3rd, 2020|Federal Medicaid issues, Safety-Net Association of Pennsylvania|Comments Off on SNAP Asks Feds to Withdraw Medicaid Financing Regulation

SNAP Asks PA Delegation to Support Another Medicaid DSH Cut Delay

In a letter to members of Pennsylvania’s congressional delegation, SNAP has asked those members to support another two-year delay of Medicaid disproportionate share (Medicaid DSH) cuts mandated by the Affordable Care Act.

Safety-Net Association of Pennsylvania logoIn the message, SNAP notes the important role Medicaid DSH payments play in helping private safety-net hospitals care for the many uninsured patients who continue to turn to them for care.

If the cut is not delayed, Pennsylvania will see its Medicaid DSH allotment from the federal government fall 40 percent in FY 2020 and 80 percent annually from FY 2021 through FY 2025.

See SNAP’s message to PA delegation members here.

 

2019-10-04T06:00:52+00:00October 4th, 2019|Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off on SNAP Asks PA Delegation to Support Another Medicaid DSH Cut Delay

SNAP Thanks PA Delegation for Supporting Short-Term Medicaid DSH Cut Delay

SNAP has written to members of Pennsylvania’s congressional delegation to thank them for voting for a temporary delay of Medicaid disproportionate share (Medicaid DSH) cuts mandated by the Affordable Care Act.

Safety-Net Association of Pennsylvania logoThe Medicaid DSH delay was included in a continuing resolution that Congress passed to fund the federal government temporarily while legislators continue to negotiate an FY 2020 federal budget.  The continuing resolution and the Medicaid DSH cut delay run through November 21.

Medicaid DSH cuts mandated by the Affordable Care Act have already been delayed several times by Congress, but if not delayed again, Pennsylvania will see its federal Medicaid DSH allotment fall 40 percent in FY 2020 and 80 percent a year from FY 2021 through FY 2025.

See SNAP’s thank you note to Pennsylvania’s congressional delegation here.

 

2019-10-03T06:00:35+00:00October 3rd, 2019|DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off on SNAP Thanks PA Delegation for Supporting Short-Term Medicaid DSH Cut Delay

SNAP Asks Congress for Help on Medicaid DSH

Prevent Medicaid DSH cuts:  that is the message the Safety-Net Association of Pennsylvania conveyed to Pennsylvania’s congressional delegation this week.

Safety-Net Association of Pennsylvania logoIn a message sent to every member of the U.S. House of Representatives from Pennsylvania, SNAP asked members to sign onto a letter to House Speaker Nancy Pelosi asking her to delay Affordable Care Act-mandated cuts in Medicaid disproportionate share payments (Medicaid DSH) that are scheduled to take effect in October of this year.

If implemented, the cut would hurt 179 of Pennsylvania’s 213 hospitals, including all safety-net hospitals, and cost the state approximately $240 million in Medicaid DSH revenue in FY 2020 and $480 million a year in FYs 2021 through 2025.

See the letter requesting action on Medicaid DSH cuts here and SNAP’s message to Pennsylvania’s congressional delegation here.

SNAP Writes to House Ways and Means Committee About Medicaid DSH Audits

The federal government should give states the option of monitoring Medicaid disproportionate share payments (Medicaid DSH) to hospitals through prospective DSH limit calculations rather than through retroactive DSH audits.

Safety-Net Association of Pennsylvania logoSNAP recently shared this view with the House Ways and Means Committee’s Health Subcommittee in response to that subcommittee’s request for suggestions from stakeholders on ways to improve the delivery of Medicare services and eliminate statutory and regulatory obstacles to more effective care delivery.

 According to SNAP, retroactive DSH audits are cumbersome, burdensome, and expensive, give rise to many disputes and appeals, and in the end yield results very similar to much simpler prospective DSH limit calculations performed by the very state governments that distribute Medicaid DSH funds.

 See SNAP’s comments to the Ways and Means Committee here.

2017-08-29T17:00:02+00:00August 29th, 2017|Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania, Uncategorized|Comments Off on SNAP Writes to House Ways and Means Committee About Medicaid DSH Audits

SNAP, Other Groups Caution PA Delegation About Health Reform Bill

The Safety-Net Association of Pennsylvania has joined 13 other groups in writing to members of the state’s congressional delegation to warn about shortcomings in the American Health Care Act, health care reform legislation currently being considered by the U.S. House of Representatives.

Safety-Net Association of Pennsylvania logoThe letter warns that the American Health Care Act would “…dramatically reduce Medicaid coverage and strain resources for this critical program.”

Read that letter here, on SNAP’s web site.

2017-05-03T06:00:03+00:00May 3rd, 2017|American Health Care Act, Safety-Net Association of Pennsylvania|Comments Off on SNAP, Other Groups Caution PA Delegation About Health Reform Bill

SNAP Comments on Proposed Medicaid DSH Regulation

The Safety-Net Association of Pennsylvania has written to the Centers for Medicare & Medicaid Services to object to how the agency proposes changing its methodology for calculating eligible hospitals’ Medicaid disproportionate share (Medicaid DSH) payments.
Safety-Net Association of Pennsylvania logoIn particular, SNAP opposes the manner in which CMS would treat payments from Medicare and third-party payers made on behalf of Medicaid-eligible individuals.
In SNAP’s view, the letter notes,

…the hospital-specific DSH limit has come to penalize the very hospitals that Medicaid DSH payments were designed to support.

The SNAP letter explains that

What concerns SNAP at this time is CMS’s apparent decision to rationalize and codify in regulations a narrower interpretation of the Medicaid DSH limit than what Congress described in section 1923(g) of the Social Security Act.

Read SNAP’s complete letter here.

2016-09-15T06:00:48+00:00September 15th, 2016|Medicaid supplemental payments, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off on SNAP Comments on Proposed Medicaid DSH Regulation
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