State budgets are not infinite. And, Medicaid continues to be the primary expenditure of most state budgets.
Providing access to quality healthcare to its Medicaid and uninsured/underinsured populations while continuing to manage or restrain costs is an on-going challenge for states. They must ensure that they are pursuing all available federal Medicaid fund-matching financing opportunities.
For states, Sellers Dorsey successfully analyzes state-only spending to identify opportunities for securing additional federal match, ensuring that the federal government is contributing their share of funding for this joint federal-state partnership. The firm is the national leader in the successful design, development and implementation of complex financial arrangements such as upper payment limit programs (UPLs), intergovernmental transfer programs (IGTs), certified public expenditures (CPEs) and provider assessments. The solutions we have created have resulted in billions of dollars in much-needed new funding for state Medicaid programs.
For stakeholders, we work on your behalf to identify potential Medicaid funding mechanisms that would result in more complete reimbursement for the costs of Medicaid services being provided.
We work closely with you and with the Centers for Medicare and Medicaid Services (CMS) to deliver solutions that will help your state or organization achieve its delivery of affordable and quality healthcare services to those who rely on Medicaid.
To ensure appropriate federal financial participation for state Medicaid expenditures, we will:
- Analyze provider reimbursement policies
- Review current sources of state match and indentify additional legitimate sources
- Evaluate state-only funded programs for federal matching opportunities
Additionally, our services include:
- Assessment of current financing mechanisms, including identification of risks and new opportunities
- Development of UPL and IGT programs, provider assessments and CPEs. This includes fiscal analysis, modeling and technical assistance with state plan amendments as well as federal approvals.
- Support throughout the federal review process, including negotiations with CMS
- Negotiating with states and stakeholders to provide adequate Medicaid reimbursements
Our highly skilled, multidisciplinary team has helped more than 20 states understand their full range of options, negotiate changes with federal officials, and successfully implement complex financing structures. Our firm works in open communication with CMS to enable a transparent process for seeking approvals. This commitment to transparency and openness has resulted in no state ever experiencing a disallowance as a result of a Sellers Dorsey initiative.
You can rely on us to provide sound technical and strategic advice that will not put you or your state or organization at risk.
To learn more, contact Brian McGuckin, Director of Medicaid Financing Services.