The Centers for Medicare and Medicaid Services (CMS) was asked by the American Hospital Association (AHA) to end its bid for a proposed rule that, under Medicaid managed care contracts, would potentially limit states’ abilities to use pass-through payments for hospitals, physicians or nursing homes.
The new rule would change compliance dates for the pass-through payment phase-down, which would restrict state Medicaid programs and hospitals ability to make payments. This could result in patients having to deal with supplemental payments.
The AHA believes this rule would essentially move up the start of the phase-out period of hospital pass-through payments from July 2017 to July 5, 2016 and only those states with pass-through payments submitted by July 5, 2016 would be able to continue during the phase-out period. AHA wants all states to be able to continue supplemental hospital payments within the context of Medicaid managed care plans so hospitals in transition from fee-for-service to managed care are assured consistent payment without interruption.
“CMS has characterized that this rule is a clarification of its policy,” AHA Executive Vice President Tom Nickels wrote. “This proposed rule, however, changes, ‘the rules of the game’ mid-stream, leaving state Medicaid programs and hospitals no time to adjust, and the result could adversely affect hospitals dependent on these supplemental payments. Therefore, the AHA requests that CMS withdraw the proposed rule and allow states and hospitals the full 10-year transition period spelled out in the May 6, 2016 final rule, which begins in July 2017.”
