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Healthcare Business News
 

Final rule issued on expanded Medicaid funding


By Jonathan Block
Posted: March 29, 2013 - 4:30 pm ET
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Although HHS on Friday released a final rule regarding the expanded 100% federal funding of the cost of new Medicaid beneficiaries, the department is still accepting comments on the methodology states can use to determine whether a new beneficiary qualifies for the enhanced funding.

That methodology is important, since if a person is not deemed “newly eligible,” then they do not qualify for the 100% federal match, but instead, the lower matching rate for those already enrolled in Medicaid.

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The 104-page final rule describes the methods states will use to determine who is eligible (PDF) for the 100% matching rate, known as the federal medical assistance percentage, or FMAP. Under the Patient Protection and Affordable Care Act, states that participate in the Medicaid expansion and enroll individuals whose annual income is up to 133% of the federal poverty level will have the costs of these new enrollees covered entirely by the federal government from 2014-16. After 2016, the federal contribution will gradually phase down, reaching 90% in 2020.

The increased FMAP becomes effective on Jan. 1, 2014.

The final rule incorporates comments received after the proposed rule was issued Aug. 17, 2011, and it includes details on the treatment of disability status and enrollment caps in states with certain demonstration projects. HHS is accepting additional comments to determine if further guidance is needed for states to effectively implement the methodology.


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