Federal Rule Would Decimate State’s Medi-Cal Program

February 6, 2020

The Centers for Medicare and Medicaid Services (CMS) released a proposed new federal rule for increased Medicaid fiscal transparency late last year called the Medicaid Fiscal Accountability Rule, or MFAR.

CSAC, along with the County Welfare Directors Association of California, submitted comments on January 31 opposing the new rule, which would limit the types of funding states can use to draw down federal financial participation (FFP) for Medicaid services.

Specifically, the rule requires that only public funds may be used to draw down FFP and would institute a condensed, three-year renewal process with significant new reporting and data requirements. If finalized and implemented by CMS, the MFAR would decimate the state’s current Medi-Cal program and impose significant workload and data requirements on the state, counties, and health care providers.

The public comment period has closed, and CMS will spend the next few months reviewing and compiling public comments. CSAC is also working with the National Association of Counties and affiliates to inform Congress of our significant concerns with the MFAR. 


  • View CSAC’s comments opposing the rule here.
  • View the CMS MFAR fact sheet here.
  • View the MFAR here:  
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