WSHA Reviews Medicaid Managed Care Rule

January 26, 2017

WSHA reviewed a recent Final Rule from the Centers for Medicare and Medicaid Services which could significantly impact payments Washington and others states receive through the Medicaid program.  Fortunately, in the case of Washington’s program we believe the change should have little impact for several years.

The Final Rule regulates the type and amount of Medicaid payments hospitals can receive through managed care plans under provider tax arrangements such as Washington State’s Hospital Safety Net Assessment program, where hospitals pay a tax, which, along with federal matching funds is used for payments to hospitals to support Medicaid services. The intent of the rule is to require states to transition from some types of these payments over a 10 year period. WSHA consulted with outside consultants and with the Health Care Authority regarding the rule. While details of how CMS will calculate the dollar limits are unclear, all parties believe these specific changes will not significantly impact Washington’s program for at least 8 years. WSHA will continue to monitor and work with HCA and the legislature if it is necessary to modify the program to comply with the CMS rule. (Andrew Busz, )


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