CMS sig­nals change in stance over Florida waiver

Modern Healthcare - - REGIONAL NEWS - —Vir­gil Dick­son

The CMS is ap­pear­ing to blink in its stare-down with Florida over Med­i­caid ex­pan­sion. The agency in­formed state of­fi­cials last week that it ten­ta­tively plans to re­new a waiver that has pro­vided Florida bil­lions in sup­ple­men­tal Med­i­caid fund­ing to help hos­pi­tals with un­com­pen­sated-care costs.

The Obama ad­min­is­tra­tion had tied re­newal of the waiver—which it warned a year ago was end­ing—to Florida’s ex­pan­sion of Med­i­caid to adults with in­comes up to 138% of the fed­eral poverty level. HHS and CMS of­fi­cials have said the ad­min­is­tra­tion does not want to pro­vide sup­ple­men­tal hos­pi­tal-care fund­ing for peo­ple that Florida could cover through a Med­i­caid ex­pan­sion. The state filed a law­suit con­tend­ing the ad­min­is­tra­tion was try­ing to co­erce it to ex­pand cov­er­age, which the U.S. Supreme Court pre­vi­ously ruled un­con­sti­tu­tional.

The CMS now ap­pears to have had a change of heart. “We have pre­lim­i­nar­ily con­cluded that 2015-2016 fund­ing should be con­sis­tent with what the fund­ing will be at $1 bil­lion, con­sis­tent with the fund­ing for LIP (Low In­come Pool) prior to 2014, to main­tain sta­bil­ity while the sys­tem tran­si­tions,” Vikki Wachino, direc­tor of the Cen­ter for Med­i­caid and CHIP Ser­vices at the CMS, said in a May 21 let­ter to the state. Start­ing in mid-2016, fund­ing will drop to $600 mil­lion as “a more sus­tain­able and ap­pro­pri­ate level to cover the state’s re­main­ing un­com­pen­sated-care costs,” she added. The new waiver would end in June 2017.

It’s un­clear if the law­suit filed by Gov. Rick Scott’s ad­min­is­tra­tion will move for­ward.

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