Double Trouble? Two Government Actions This Week May Provide Insight for the Future of GEMT Programs

Two actions this week in DC may be signaling the future of GEMT programs.

First, CMS released a proposed rule Monday, that according to the language in CMS’ release, “would end states’ ability to exploit a health care-related tax loophole currently used by seven states to generate billions in federal Medicaid payments—without contributing their fair share or expanding care for Medicaid enrollees”. 

Second, the House Energy and Commerce Committee released their 160 page heath package for the Budget Reconciliation Act. The legislation would limit states’ ability to levy taxes on providers to finance Medicaid programs and changes Medicaid eligibility to reduce the number of Medicaid enrollees. 

The “Provider Tax” limitation language starts on page 64, line 19 of the document here.

News reports related to these two actions are below.

Recall that the CMS OIG is still auditing GEMT cost reports, and are due to release the results from their audits this year (https://oig.hhs.gov/reports-and-publications/workplan/summary/wp-summary-0000786.asp),

The OIG initiated these audits following a notice from CMS to state Medicaid offices detailing their concerns about non-allowable costs being included in some GEMT cost reports (https://www.medicaid.gov/federal-policy-guidance/downloads/cib08172022.pdf).

Providers who are currently participating in GEMT programs, or are awaiting State Plan Amendment approvals from CMS, should monitor these development closely.