Medicaid Fiscal Accountability Regulation (MFAR) Update 

Medicaid Fiscal Accountability Regulation (MFAR) Update 

This rule looks to limit provider taxes levied by states on Medicaid providers that are used to maximize federal matching funds (sometimes called FMAP).  The rule would also remove exemptions and exceptions to these taxes.  Currently Washington uses exemptions and exceptions for high Medicaid facilities, large facilities, and CCRC/CCRC like facilities.  The exemption/exceptions for large facilities and CCRC/CCRC like facilities may be at risk under this proposed rule.

Over the past few weeks LeadingAge Washington along with skilled nursing providers and WaCCRA representatives and in coordination with LeadingAge National  held phone calls with Washington’s congressional delegation to inform them of the effect that MFAR could have here in Washington. We were able to hold phone calls with both Senator Cantwell’s and Senator Murray’s office as well as most of our Representatives. LeadingAge National drafted a letter that was signed by 27 Representatives from around the country, including Representatives Kilmer, DelBene and Schrier from Washington.

In addition to the phone calls, we asked that facilities and residents submit comments to CMS opposing the proposed rule. Overall CMS received nearly 4,000 comments including hundreds from WaCCRA and other residents living in Washington Life Plan Communities.

We thank everyone that participated in a phone call or submitted a comment.

On Wednesday February 12th, CMS Administrator Seema Verma posted a response on the CMS blog in regards to the comments.  She states that the reaction to the proposed rule is overblown and that if states follow the rules and laws around the Medicaid program, they should be at no risk of losing federal matching dollars.  As LeadingAge Washington and LeadingAge National have previously stated, we believe this to be inaccurate.  The vagueness of the rule and the removal of exemptions/exceptions, could lead to more financial problems for nursing homes in the state of Washington.  We will continue to fight against this proposed rule.

You can read the blog post here

We will keep you posted with any opportunities to get involved and as any new information comes available.



David Carter, Director Health Care Finance & Policy, LeadingAge Washington | c: 360.888.5702