Health Law & Business News

Pa. Loses $3M Medicaid Reimbursement Fight With HHS

July 26, 2018, 8:28 PM

Pennsylvania will have to return $3 million in Medicaid reimbursement to the Centers for Medicare & Medicaid Services because federal Medicaid funds can’t cover provider training costs.

The U.S. Court of Appeals for the Third Circuit July 25 ruled a State Medicaid Director Letter (SMDL), published in 1994, was an interpretive rule rather than a substantive rule and prohibited states from claiming provider training costs as part of the cost of administering a state’s Medicaid plan.

The state used the money to pay for training nursing home staff alternatives to using physical and chemical restraints on Medicaid patients.

The case...

To read the full article log in. To learn more about a subscription click here.