CMCS Releases Informational Bulletin Clarifying Hold-Harmless Policy

CMS’ Centers for Medicaid and CHIP Services (CMCS) has released an Informational Bulletin stating its interpretation of federal laws related to Medicaid payments where the state share is derived from a provider tax. The bulletin specifically addresses private arrangements among taxpayers to redistribute payments to mitigate the impact of provider taxes. CMCS takes the position that a hold harmless arrangement may exist even if the unit of government imposing the provider tax is not involved in or aware of the redistribution of Medicaid payments. In addition to this statement of policy, CMCS states that they will expect states to have information regarding provider tax arrangements and potential hold harmless arrangements available during the federal approval process and recommends that as necessary, states include provisions requiring the sharing of such information in their provider participation agreements.