In the final rule from the Centers for Medicare & Medicaid Services (CMS), the agency clarifies:
- entities involved in financing of the non-federal share of Medicaid payments must be a governmental entity
- the documentation required to support a Medicaid certified public expenditure
- Medicaid reimbursement for health care providers operated by a governmental entity is limited to an amount that does not exceed the health care provider’s cost of providing services to Medicaid individuals
- all health care providers are required to receive and retain the full amount of total computable payments for services furnished under the approved Medicaid state plan
- conforming changes to provisions governing the State Child Health Insurance Program to make the same requirements applicable
Published May 2007.
Prepared May 2007.