HHS Proposes Cap on State Payments to Medicaid Providers

The Trump administration announced a proposal to revise the limit on how much states can pay providers directly for Medicaid services.

Under the proposal (RIN 0938-AV69) released Wednesday, payments for inpatient nursing facilities, inpatient and outpatient hospitals, and qualified practitioners will be capped at 100% of what Medicare pays for these services in states that have expanded Medicaid eligibility and 110% in non-expansion states. If a particular Medicaid-covered service lacks a published Medicare payment rate, the CMS will set payment limits at 100% of what a state approved under its Medicaid plan.

The proposed rule follows guidance released last ...