As three Democratic and GOP Governors meet at the White House today to discuss how going over the so-called 'fiscal cliff' will impact states, the Alliance for Quality Nursing Home Care (AQNHC) said it is critical for the state lawmakers to explain why upholding state Medicaid flexibility is essential to helping narrow facility funding gaps caused by the ongoing cuts and pressure on Medicare-funded Skilled Nursing Facility (SNF) care -- slated for $65 billion in cumulative funding reductions over the next ten years, according to Avalere.
Alan G. Rosenbloom, President of the Alliance, said the meeting with National Governors Association (NGA) Chairman Jack Markell (D-DE) and Governors Mark Dayton (D-MN), Mike Beebe (D-AR), Gary Herbert (R-UT), Scott Walker (R-WI) and Mary Fallin (R-OK) underscores the importance of ensuring President Obama and Congress both understand the importance of retaining Governors' ability to use "provider assessments" to generate additional federal resources to help meet their most vulnerable citizens' long term and post acute care needs.
"As SNF providers and their patients brace for sequestration in just four weeks, and nearly $4 billion in FY 2014 Medicare funding reductions, we urge Governor Markell and his colleagues to ensure President Obama fully understands that limiting their state level ability to utilize provider assessments to help bridge facility funding gaps would be harmful to SNF patients and detrimental to staffing stability," said Rosenbloom. "Limiting provider assessments will also shift still more Medicaid costs onto state budgets at a time the nation's Governors are already struggling to pay for a wide range of other onerous federal mandates."
Federal law currently allows Governors to use provider-specific assessments to help pay for their share of Medicaid funding, and the amount of such revenues that can be rebated to providers is capped at 6%. States have disproportionately, and historically, relied upon provider assessments to fund their SNF Medicaid programs compared to other Medicaid providers -- and substantially more SNF provider assessment programs operate at or near the permissible 6% ceiling than those for other providers.
Recent federal budget proposals reduce the maximum 6% assessment threshold anywhere from 5.5 to 3.5 percent - with cuts ranging from $11.3 billion to $21.8 billion in payments to all providers over a multi-year period. Rosenbloom noted 40 states have already been forced to freeze or cut Medicaid-funded nursing home care since 2009, and said the SNF sector -- with 80 percent of our patients dependent upon Medicare or Medicaid funding for their care - is especially sensitized to the cumulative negative impact of Medicaid cuts at the state level, and Medicare cuts from Washington.
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