North Texas Hospitals Face $27 Million Penalty in Medicaid Dispute
Hospitals in the Dallas-Fort Worth region were overpaid by $27 million in federal funds to provide health care for the uninsured, according to a new order from the Obama administration, which is threatening to take the money back.
Federal health officials allege that Texas has allowed private hospitals to leverage donations to local governments in order to improperly draw matching federal funds. Texas officials say they will challenge the decision, which appears to contradict an earlier directive by the Obama administration.
It’s the latest development in a protracted tug-of-war over a multibillion-dollar pot of mostly federal Medicaid funding known as the 1115 waiver, which Texas has come to rely on when footing the bill for its uniquely large population without health insurance. In May, Texas and the federal government agreed to a 15-month renewal of the funding stream, despite the Obama administration's preference that some of the money be used to buy health insurance for low-income Texans under the Affordable Care Act. Nearly one in five Texans is uninsured, according to the federal government, the highest rate of any state.
The 1115 waiver, set to expire in December 2017, allows local governments in Texas to gather funding — such as property tax revenue raised by county hospital districts — which the federal government then supplements. The combined revenue, of which roughly 60 percent comes from the federal government, is divided up into two pots: one reimbursing hospitals for uncompensated care and another paying for “innovative,” cost-effective health care programs. The waiver’s latest iteration offers $3.1 billion for each funding stream over one year.
Read more: https://www.texastribune.org/2016/09/07/north-texas-hospitals-face-27-million-cut-medicaid/
