The California Medical Association (CMA) recently joined all of the state medical societies and some national specialty societies in sending a letter to the Centers for Medicare and Medicaid Services (CMS) urging the agency to withdraw the proposed Medicaid Fiscal Accountability Regulation (CMS-2393-P) and instead work with states, physicians and patients on alternatives that will not only ensure efficient use of taxpayer dollars, but that will also protect patient access to Medicaid services. 

The proposed rule would significantly reduce the federal commitment to the Medicaid program without appropriate data and a thorough impact analysis.  The letter asks the agency collect data on the current state funding mechanisms and how the dollars are actually spent in each state, to make more informed policy decisions before CMS overhauls the Medicaid financing structure. 

The proposal represents a substantial shift in the state-federal Medicaid partnership and a reversal of more than two decades of policy that allowed states different options for financing our share of medical care in order to receive federal Medicaid matching dollars. For years, all 50 states have used hospital fees, Medicaid managed care plan taxes, intergovernmental transfers, state special funds or other local sources of funding to receive a federal match. The proposed rule would restrict every state’s ability to use such funding for the non-federal share of Medicaid financing and it  does not establish clear standards by which future state Medicaid funding will be reviewed.

For more information see CMA’s “Medicaid Fiscal Accountability Regulation Advocacy Summary,” California Medi-Cal Fact Sheet and the Medi-Cal enrollment numbers by county.