Health Equity
Medicaid Enrollment Touches 39% of the Residents of The District of Columbia; DC’s 70/30 FMAP is Vital for the Maintenance of Health & Human Services
A reduction in the District’s FMAP would not lead to long-term government savings and would have a ripple effect throughout the entire health system in the DMV, crippling access to care for not only Medicaid beneficiaries but also all those who live, work, and visit the District of Columbia, including members of Congress and their staffs.
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Why does DC receive an Enhanced FMAP Rate?
The DC FMAP rate of 70% established by the Revitalization Act resulted from bipartisan analysis, discussion, and negotiation by Congressional leadership aiming to balance fairness with the District’s restricted ability to generate revenue. Congress recognized that the District of Columbia faces unique financial challenges due to its non-state status and the significant amount of federally-owned land within its boundaries. The District is unable to tax non-residents’ earnings, so these workers pay no taxes to support the infrastructure and services, such as roads, public safety and emergency services that they benefit from in the District. The District is also unable to tax up to 40% of the real property within its borders due to statutory restrictions.
Why are we concerned about DC's FMAP now?
Members of Congress have proposed reducing the DC FMAP to the statutory minimum for all other states, which is currently 50% (but could be reduced even more). Such a change would impact every physician and every practice, regardless of type, location, and payers contracted. Even practices who take no insurance will not be able to send patients for specialist care, hospital admissions, or other types of care.
What can MSDC members do?
- If you know a member of Congress or staffer, reach out to them and share how DC cuts will hurt your patients.
- Share your relationships and outreach with hay@msdc.org so we can help coordinate advocacy efforts.
- Email hay@msdc.org if you would like to be paired with a physician member of Congress office and trained by MSDC staff on how to reach out.
Resources
- DC FMAP cut fact sheet
- California Medical Association fact sheet on Medicaid cuts
- MSDC and healthcare association letter to Congress arguing against DC FMAP changes.
- MSDC original story on Medicaid changes.
News, Statements, and Testimony on Health Equity Issues
CareFirst Announces Accelerated Payments for Providers
On Friday, CareFirst BlueCross Blue Shield announced it would be providing $170 million in accelerated and advanced payments to certain providers to alleviate the financial strain of COVID-19.
The program will be available to CareFirst providers participating in the Patient-Centered Medical Home (PCMH) program as well as certain specialty independent practices. The funds available will include:
- Advanced lump-sum payments, increased fee schedules and monthly cash advances for qualifying PCMH panels;
- Monthly cash advances for pediatricians and rural primary care physicians who need additional assistance, independent practices in certain specialty areas (including OBGYNs and behavioral health providers); and
- Cash advances to hospitals demonstrating need in Maryland, DC, and Northern Virginia.
The application process for advanced payments opened on CareFirst's website on April 13. All providers interested are asked to complete an Accelerated Payment Request form by April 24 to be considered for disbursement.
With federal and local funds at the moment on hold, this is a potentially useful fund for physician practices to consider to continue operating. This also mirrors the advanced payment program CMS initiated for Medicare providers.
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