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CMS Issues Guidance on Provider-Related Donations under Medicaid

The Centers for Medicare & Medicaid Services (CMS) issued a letter May 9 to state Medicaid directors on acceptable and unacceptable use of provider-related donations for the Medicaid Program. Provider-related donations are voluntary payments providers make to a state or local government. According to the guidance, if a provider enters into a public-private partnership to provide non-Medicaid services and, as a direct result, the provider receives additional Medicaid base or supplemental payments the provider might not otherwise have received under the current approved state plan, CMS will consider this exchange in value by the private entity to the public entity to be a non-bona fide donation. CMS will not approve state plan amendments (SPAs) that include non-bona fide donations as a portion, or all, of the non-federal share of Medicaid payments. Payment methodologies contingent upon the receipt of a non-bona fide donation would also be grounds for disapproval of a SPA.

Please contact Xiaoyi Huang, JD, director of policy, at xhuang@essentialhospitals.org or 202.585.0127 with questions.

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