Mostly Medicaid Addresses Society of Actuaries on OIG Scrutiny of State Medicaid Financing Mechanisms (IGTS, Provider Taxes, UPL and DSH)

Birmingham, AL, August 13, 2015 --( Mostly Medicaid experts assisted the Society of Actuaries in reviewing recent moves by federal HHS OIG to resume scrutiny of state financing methods such as intergovernmental transfers, upper payment limit calculations and provider taxes. Clay Farris of Mostly Medicaid predicts a new wave of federal scrutiny around state Medicaid financing in the next 18 months.

Clay Farris from served as a guest speaker to the Society of Actuaries on July 24, 2015. His talk included review of recent OIG efforts to strengthen scrutiny of state financing mechanisms. Attendees provided additional insights during the discussion portion of the presentation. When interviewed, Mr. Farris “was highly impressed with the group and their handle on Medicaid complexities.” The main theme of Mr. Farris’ talks was the repeating pattern of OIG observing state financing schemes, auditing example states, recommending changes to regs to CMS, and then CMS adopting some OIG recommendations. “We are nearing the part of the cycle where CMS will need to respond to OIG audit findings again,” said Mr. Farris.

Per, Mr. Farris, there are several recent indicators that OIG and CMS will soon release new regs in this area, including: 1) a return of blatant use of IGT/provider tax rewards going to non-Medicaid uses; 2) increased pressure on state shares with the ACA-driven wind-down of Disproportionate Share Hospital (DSH) funds; and 3) some traditionally quiet providers now voicing opposition to fees now that they are receiving a smaller return than in previous years.

In addition to appearances like these, other indicators of Mostly Medicaid's growing influence include large gains in the LinkedIn group it manages for industry professionals. According to one marketing analyst at the firm, the group "now includes nearly 6,000 key decision makers in the Medicaid industry. 45% of our members are in director level or above roles, suggesting the information they get from Mostly Medicaid on a daily basis is a part of important decisions being made in their organizations. And if you look out our growth curve since 2008, we have Mostly Medicaid become the most trusted source of industry information for the majority of the segments. We have folks from all segments, including hospital, consulting, finance, government, insurance, advocacy - just to name a few of the slices." provides consulting and training services for both public and private sector clients in the Medicaid industry. The Mostly Medicaid publishing audience includes 10,000 Medicaid industry professionals, decision makers and influencers. Mostly Medicaid offers a unique value in the Medicaid industry by focusing on data-driven business perspectives rather than policy-only or advocacy-only positions. Mostly Medicaid was one of the first organizations to actually use the term "Medicaid industry."

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