CMS Proposes to Eliminate Certain Medicaid Payments to Third Parties

The Centers for Medicare & Medicaid Services today issued a proposed rule that would eliminate 2014 regulatory text allowing states to reassign Medicaid payments to third parties on behalf of certain providers, primarily independent in-home personal care workers, for benefits customary for employees. “We are concerned that these provisions are overbroad, and insufficiently linked to the exceptions [to direct payment] expressly permitted by statute,” CMS said. The agency does not formally track the amount of reimbursement reassigned to third parties by states, but estimates that “unions may currently collect as much as $71 million from such assignments.” The proposed rule will be published in the July 12 Federal Register with comments accepted for 30 days.