Lloyd A. Bookman

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311 appearances 1 recordings 1 series first heard Jul 2026 last heard 17 Jul

Lloyd A. Bookman’s voice in public audio — every appearance, attributed to the second.

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AHLA's Speaking of Health Law · One Year In: Implementing the Medicaid Provisions of the Working Families Tax Cut Act · 17 Jul 2026 podcast

It seems that under this um uh interim f under the proposed rule that's not the case.

Under the proposed rule it's appears that they're going to apply this on a service by service provider by provider basis.

So for example, if you're talking about an inpatient service,

looks like they're gonna say, well, what would Medicare have paid for that particular service to that particular provider, including the DRG base rates?

Um, you know, IME, GME add ons and the like, what would have been paid?

And that's the limit for that particular service, 100% or 110% Medicare.

Sounds pretty unworkable to me.

Sounds sounds terrible.

Um for the gr and then they have a another provision that's really important for the those states that have existing um state directed payment programs that will meet the grandfathering requirements.

they're um going as I mentioned earlier, the if you're grandfathered, you're you're gonna you can exceed the um a hundred percent or a hundred ten percent of Medicare, but you have to

lose ten percent of your state directed payments each year uh up until uh twenty thirty two uh until you uh excuse me each each year until you actually hit the Medicare uh hundred percent or hundred ten percent limit.

The question is how's that grandfathered amount going to be computed?

And what the uh

Proposed rule says is we're gonna take

Basically the amount of your state directed payment pool the the the

As of July uh fourth, twenty twenty five.

А лесе це більон долер.

And then once we start implementing uh the grandfather in twenty twenty eight when the grandfathering

period reductions start, we're gonna reduce that um in my example one billion dollars.

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