The Centers for Medicare & Medicaid Services (CMS) released a proposed rule to reduce the payment rate limit for certain Medicaid State directed payments (SDPs) with inpatient hospital services, outpatient hospital services, nursing facility services, and qualified practitioner services at an academic medical center to 100% of the total published Medicare payment rate for a Medicaid expansion state, or 110% of the total published Medicare payment rate for a non-expansion Medicaid state.
The rule proposes to extend the payment rate limit to all SDPs for all services in all states, the District of Columbia, and U.S. territories beginning on or after January 1, 2029. They also proposed to establish a limit for targeted Medicaid fee-for–service payments.
Comments are due by July 21.