An Independent Analysis of the Medicaid Fiscal Accountability Regulation (MFAR) and its Impacts on Florida’s Medicaid Program

The federal Centers for Medicare & Medicaid Services (CMS) proposed a rule in November 2019 that, if enacted, will significantly change the way states finance their Medicaid programs and supplemental payments to providers. The stated intent of the proposed Medicaid Fiscal Accountability Regulation (MFAR) is to increase Medicaid program transparency and accountability and strengthen the fiscal integrity of the Medicaid program; however, the proposed rule could make it much harder for states like Florida to pay for their share of Medicaid costs. 

If finalized, the rule could require many states to change how they finance their Medicaid programs and, in the process, eliminate some financing options that have long been available to states. These changes would dramatically affect state budgets and could lead to significant cuts to benefits, coverage, and provider payments.

Florida TaxWatch has undertaken an independent review to assess the impacts of certain key changes proposed by MFAR that would have a far-reaching and dramatic impact on Florida’s Medicaid program, Florida’s safety-net providers, the 3.8 million Medicaid-eligible Floridians, and Florida taxpayers. Florida TaxWatch is pleased to present this summary report and its recommendations, and we look forward to a continued discussion with Florida lawmakers and policymakers.