New Medicaid rule would discourage provider reimbursement cuts

The Obama administration has proposed a rule that would make it harder for states to reduce Medicaid payments to nursing homes, doctors and hospitals. The rule would help federal and state officials implement the broad expansion of Medicaid in 2014 when the Affordable Care Act takes effect, The New York Times reports.

Administration officials have said the rule is an attempt to make sure Medicaid recipients have the same access to care as the general population under healthcare reform. In 2014, close to half of the 34 million uninsured will get their healthcare coverage through Medicaid. Like the proposed CMS rule for Medicaid, the administration's rules requires states to monitor and analyze recipients' access to care and implement plans to fix potential roadblocks. Data from these analyses, The Times reports, equip nursing homes, doctors and hospitals with a much stronger tool to negotiate higher reimbursement rates. States have criticized the proposal as federal over-reaching.

The rule does not apply to health maintenance or managed care organizations, which states with troubled budgets are increasingly turning to for help in managing beneficiaries. Additionally, in accordance with the administration's view that recipients are the experts when it comes to accessibility, states will be required to periodically survey beneficiaries. The rule will be published in the Federal Register on Friday.

05-04-2011 09:12 (EDT)