AHCA: Congress Passes FY 2023 Budget

Congress passed the FY 2023 budget, preventing a government shutdown. AHCA flagged two items of note in the 4,000-plus page budget:

1. SNFs and ALs have been left alone. AHCA reports that, while there were attempts to include some of the onerous SNF regulatory provisions that Congress considered in mid-2021, those attempts were thwarted in this legislation.
2. The budget phases out the additional federal resources that states have been getting for Medicaid during the pandemic. This is the enhanced Federal Medicaid Assistance Percentage (FMAP) included in the Families First Coronavirus Response Act. Until now, states have been getting an additional 6.2% FMAP. The bill phases out the enhancement during 2023:

                ◼️ From April to June, the increased FMAP would be 5%. 

                ◼️ From July to September, it would be 2.5%. 

                ◼️ From October to December, it would be 1.5%. 

                ◼️ On December 31, 2023, the enhanced FMAP would end entirely.

To maintain the ability to draw down the enhanced FMAP in 2023, states must take certain steps towards redeterminations for beneficiaries to ensure continued Medicaid eligibility and, therefore, Medicaid payments to providers. ACHA says that the phase out is both good and bad news for states. Currently, the enhancement is tied to the COVID-19 Public Health Emergency (PHE). The prevailing thought has been that the PHE will end on April 11, which would mean the enhanced FMAP would go away all at once at the end of that quarter. This budget would allow a portion of the enhanced FMAP to continue through 2023.

On the other hand, it is possible that HHS will keep the PHE going beyond April 11. If that’s the case, this budget means less money to states. Of note, the three-day stay waiver is not affected and remains tied to the PHE.