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Enhanced Federal Medical Assistance Percentage

The ACA, § 2001, authorized the use of an FMAP of 100 percent for individuals who are newly eligible because of Medicaid expansion. In addition, the ACA, § 1202, required that Medicaid payments to primary care providers be at least those of the Medicare rates in effect for CYs 2013 and 2014. States can claim 100 percent FMAP for the difference between the Medicare rate and the States’ Medicaid rate. We will review States’ Medicaid claims to determine whether the States correctly applied enhanced FMAP payment provisions of the ACA. 

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
Nov-16 Centers for Medicare & Medicaid Services Enhanced Federal Medical Assistance Percentage Office of Audit Services W-00-17-31480; various reviews 2018

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