Hospitals see danger to SDPs in fraud fight
Hospitals are worried that a coming Trump administration fraud-fighting effort will go after Medicaid state-directed payments (SDPs). The concern was raised by various hospital advocates responding to the administration’s solicitation for targets in its coming anti-fraud regulations, called the Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH). That request for information (RFI) specifically asked about fraud-fighting…
Despite delays, hospitals optimistic on SDPs
Although at least one state has waited nine months for CMS approval of its state-directed payment (SDP) plan, hospital executives said the approval process continues to churn. So far this year, CMS has approved $26.2 billion in hospital-focused SDPs, according to a FastFinance count of the list of approved SDPs. That amount includes both the…
Medicaid directed payments draw scrutiny, potential changes
As annual Medicaid state-directed payments (SDPs) exceed $100 billion annually, congressional advisers are calling for transparency, while critics emphasizing the need for change. Medicaid SDPs, which primarily benefit hospitals, have surged both in their number and total spending, according to a recent staff report from the Medicaid and CHIP Payment and Access Commission (MACPAC). In…