We-Have-To-Pass-It-To-See-What’s-In-It Fact of the Day

Can the Secretary of Health and Human Services tell the states how much they have to pay doctors and hospitals? You probably didn’t see that section when you last perused the 2,700 page bill. But here is Marilyn Serafini, writing in The Washington Post:

Sebelius also will soon provide guidance to states on Medicaid reimbursement rates for doctors and hospitals. Several states are considering reducing Medicaid payments to providers, but there’s concern that slicing rates too deeply could cause some doctors to close their doors to Medicaid patients. The HHS guidance is intended to help states decide which cuts go too far.


Comments (9)

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  1. Ken says:

    This is really amazing. First I’ve heard of HHS being able to dictate how much states will have to pay providers.

  2. Ken says:

    There have been a number of projections of Medicaid costs, by the states themselves and by M&R. I don’t think any of them anticipated this.

  3. Paul H. says:

    All I can say is “Wow.”

  4. Vicki says:

    This is really quite amazing.

  5. Linda Gorman says:

    ObamaCare requires that state Medicaid programs match Medicare rates for primary care providers. This was a big selling point of the bill as Medicaid has typically been below Medicare and the docs that would be affected seemed not to realize that there was no guarantee that the feds wouldn’t reduce Medicare rates to Medicaid levels.

    In other contexts I believe that this is called Rope-A-Dope.

  6. Devon Herrick says:

    The PPACA provides federal funds for states to increase Medicaid provider rates to Medicare levels. But the federal funding is only for two years. A significant portion of the cost of Medicaid expansion that will be borne by the states is the cost of compensating providers at levels sufficient to entice them to treat the (expanded) Medicaid population.

  7. Seamus Muldoon MD says:

    That clicking sound you hear is another domino falling…

  8. Federal law has always limited states’ powers to set Medicaid provider rates. In 2008, physicians and pharmacists successfully sued Gov. Schwarzenegger for lowballing rates, and similar lawsuits persisted throughout his term (http://statehousecall.org/?p=463).

    Unfortunately for them, he responded by paying them in IOUs, or delaying payment for months. If there’s no money, all the lawsuits in the world cannot protect one from the consequences of choosing to work for the government.

  9. Neil H. says:

    I think what John Graham is implying is that the federal goverment (Sebelius) can limit how low state provider rates can go, but in the past they have engaged in benign neglect. Am I right?