Baxter Morgan
speaker
266 appearances
1 recordings
1 series
first heard Jul 2026
last heard 28 Jul
Baxter Morgan’s voice in public audio — every appearance, attributed to the second.
Trend
recordings per month · last 12 monthsRecordings per month over the last 12 months — 1 in all, peaking in Jul 2026 with 1.
Appearances
Getting another.
So we we saw increases up to cost on certain payment programs, like in the fee-for-service space.
But then starting around 2016, um, states began to be able to use these Medicaid managed care add-on payments in state directed payment programs that allowed states to pay up to an average commercial rate for the services.
provided through those those managed care relationships.
With the idea being that, you know, CMS and the states wanted Medicaid managed care to be a competitive product with a regular commercial line and wanted state, you know, you can't discriminate against patients, but if you're not getting paid for treating some folks, you're going to find ways to avoid treating those folks.
That's just reality.
And so
the opportunity to pay these additional rates, which still, you know, weren't getting hospital providers or others up to their cost overall, um, it required that non-federal share.
And so states became increasingly reliant on provider taxes.
And like Kat said,
You know, that that threshold of a six percent standard sort of became a default.
We we viewed it as a cap, but really what it was was a safe harbor mechanism that said as long as you're under that, there's a presumption that this is not a hold harmless arrangement.
And so I mean, I think this kind of goes to one of the the main limits you see as you're thinking about provider taxes, which is this is going to become even more important as we go forward.
that, you know, taxes have to be uniform, they have to be broad based, and they can't constitute a hold harmless arrangement.
And so CMS looked at that six percent line as sort of a a okay, you know, you're under six percent.
You're probably not con you're probably not an indirect hold harmless.
Cause if you think about it,
A state would love to tax hospital providers, you know, 20% of revenue, use that to draw down all this money, and then only pay the hospitals a a limited portion of it.
And so I think the CMS and the the policymaking side was look, we need to find a limit that minimizes that risk that says, okay, look, you can tax this, you use this money.
Um
Showing 61–80 of 266 · page 4 of 14
← Previous
Next →