This week, the Centers for Medicare and Medicaid Services (CMS)
announced they would not move forward with their proposed
Medicaid Fiscal Accountability Rule (MFAR). The federal rule,
announced at the end of 2019, was intended to increase Medicaid
fiscal transparency but attracted a host of responses from state
and local governments voicing concerns, including the state of
California and CSAC.
The proposed rule would have restricted the use of non-public
funds for the non-federal share used to draw down Federal
Financing Participation. Additionally, CMS would have required
substantial new data reporting requires and introduced a
significant amount of ambiguous undefined terms. The finalization
of this rule would have threatened the state’s current and future
Medi-Cal program and impose significant workload and data
requirements on the state, counties, and health care providers.
CSAC, along with the County Welfare Directors Association of
California,
submitted comments on January 31 opposing the new rule. The
State Department of Health Care Services also opposed the rule
during the comment period as well. After the official comment
period was closed and the country began diverting financial and
workforce resources to combating the impacts of the COVID-19
pandemic, CSAC urged California’s Congressional leadership to
work towards suspending any movement on the CMS rule as the
financial strains on the state and the medical needs statewide
became apparent.
After CMS received more than 4,000 public comments during the
comment period, and ongoing pressure from states, local
governments, and organizations throughout the country, CMS
Director Seema Varna announced on Twitter that the rule was being
withdrawn. Please note that the rule has not yet been formally
withdrawn and thus may be quickly revived, so caution is still
warranted. But for now, CSAC is pleased with CMS’s public
announcement and will continue to pay close attention to this
issue.
