Medicaid nursing facility payment approaches

This Center for Medicaid & CHIP Services (CMCS) Informational Bulletin (CIB) describes actions that states can implement using existing Medicaid authority. CMS encourages states to assess their approach to payments to long-term care providers and utilize flexibilities provided by section 1902(a)(30)(A) of the Social Security Act (the Act) in establishing Medicaid base and supplemental payments, as appropriate, to provide adequate, performance-driven nursing facility rates to ultimately achieve better health care outcomes and address longstanding inequities for Medicaid beneficiaries residing in nursing facilities. States can implement a number of initiatives immediately through the Medicaid state plan, waiver, or demonstration process, which are highlighted below. Through initiatives like these, we expect that Medicaid beneficiaries residing in nursing facilities will receive better care through the collaboration of CMS and states to realize the goals outlined in the White House Biden-Harris Administration’s Nursing Home Reform Action Plan.