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
March 11 UPDATE on Change Healthcare Cybersecurity Issue
This weekend, the Centers for Medicare and Medicaid Services announced a new opportunity for physicians impacted by the cyberattack and resulting disruptions with Change Healthcare to request advanced Medicare payments to help with cash flow disruptions. The details of the program, terms, and the steps needed to apply can be found in the links below.
Fact Sheet - https://www.cms.gov/newsroom/fact-sheets/change-healthcare/optum-payment-disruption-chopd-accelerated-payments-part-providers-and-advance
CMS Statement - https://www.cms.gov/newsroom/press-releases/cms-statement-continued-action-respond-cyberattack-change-healthcare
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Original post
Change Healthcare, a data analytics, technology, and clearinghouse subsidiary of UnitedHealth Group (UHG), experienced a cybersecurity incident on February 21, 2024. More than a week after the attack, physician practices, hospitals, and retail pharmacies continue to experience disruptions in electronic health care transactions, including claims processing, eligibility verification, and electronic prescribing. The AMA has created a dedicated webpage on this issue, which will be regularly updated as more information becomes available.
For more from the AMA on this issue, please see:
- AMA letter to the Department of Health and Human Services (HHS) detailing the significant challenges physicians face due to the Change incident and requesting that HHS use all its available authorities to ensure that practices can continue to function and patients can continue to receive the care that they need.
- AMA statement on HHS response to Change Healthcare cybersecurity incident.
- AMA dedicated webpage on this issue, which will be regularly updated as more information becomes available.
As a reminder, you and your members can submit information about experiences stemming from the Change Healthcare cybersecurity incident to the ama.advocacy@ama-assn.org inbox. Advocacy staff will use the information in our discussions with the Biden Administration as well as UnitedHealth Group (UHG).