AAMC Chief Health Care Officer Jonathan Jaffery, MD, MS, MMM, FACP, issued the following statement on a new rule proposed by the Centers for Medicare and Medicaid Services:
“The AAMC is deeply concerned about the negative consequences that this new rule related to state directed payments (SDPs) proposed by the Centers for Medicare and Medicaid Services (CMS) would have on access to care for Medicaid enrollees and the harm these changes would cause to the vulnerable populations served by Medicaid: children, older adults, individuals with disabilities, and those in rural and underserved communities.
AAMC-member academic health systems and teaching hospitals, medical schools, and their affiliated physician faculty are committed to caring for Medicaid patients. These institutions provide nearly a third of all Medicaid inpatient care, underscoring the indispensable and outsized role they play in meeting the needs of our most vulnerable populations and communities.
The proposed rule, CMS-2449-P, implements provisions of the One Big Beautiful Bill Act (OBBBA) related to caps on SDPs. States use these key payments to invest in workforce development and rural health, improve access to specialized care, and address behavioral health needs. This rule goes beyond the statutory language by adding unnecessary restrictions to supplemental payments to providers that are not included in the OBBBA.
CMS’ newly proposed restrictions on Medicaid supplemental payments to academic medical centers will result in further reductions to Medicaid programs that support initiatives critical to bolstering the health of vulnerable populations. Ultimately, the provisions of the proposed rule would exacerbate the funding gap to the detriment of care for complex patients, reducing access and coverage nationwide.
The AAMC urges CMS to focus on implementing the provisions of the OBBBA that are consistent with the statutory language and to withdraw the proposed provisions that go beyond the statutory framework.”