Trump's Medicaid Reforms Are a Huge Success

Trump's Medicaid reforms are a huge success

Too often, policymakers are stuck fighting the last war. That’s what is happening in today’s debates over Medicaid. With states facing difficult budget decisions, Medicaid inevitably draws attention because it is the single largest line item in most, if not all, state budgets. But how lawmakers choose to address these pressures will determine whether patients are protected and access to care is preserved, or state governments inadvertently trigg…

CMS gives updates on upcoming Medicaid state-directed payment limits

CMS has issued guidance to Medicaid programs about implementing required restrictions on the state-directed payments (SDPs) made through Medicaid managed care organizations (MCOs). The budget reconciliation law known as the One Big Beautiful Bill Act (OBBBA) includes a provision that all SDPs submitted after July 4 for hospitals must be limited to the Medicare rate in Medicaid expansion states and 110% of Medicare in non-expansion states. If the…

CMS issues preliminary guidance on Medicaid state-directed payments as part of OBBBA implementation

The Centers for Medicare & Medicaid Services Sept. 9 issued preliminary guidance regarding the implementation of certain state-directed payment provisions in Section 71116 of the One Big Beautiful Bill Act. CMS sent a letter to stakeholders with information regarding “applicable rating period criteria,” preprint status criteria, the definition of a “completed preprint,” the definition of “good faith effort” and limits for grandfathered SDPs. CMS…