Medicaid Eligibility Under the One Big Beautiful Bill Act: Our Expert Breaks it Down With Host Kevin Chmura, CEO of Panacea Healthcare Solutions and Guest Brian Herdman, Director, Financial Reimbursement Services, KA Consulting Division In this episode of Beyond the Bottom Line, Kevin Chmura is joined by policy expert Brian Herdman to discuss how the One Big Beautiful Bill Act is set to impact Medicaid eligibility, what this critical issue means for hospitals and healthcare providers, and how these changes can affect your bottom line. Kevin and Brian dive into not only what changes providers can expect to see right away, but also those changes which will be coming into play in the next few years, and how to best prepare before they happen. They also explore what challenges hospitals can expect to see as a result of this bill’s passage, as well as if there are any positives for healthcare systems or providers. Episode transcript available below. Kevin Chmura Hi, and welcome back to Beyond the Bottom Line, Panacea’s Podcast exploring the business and policy issues that matter most to healthcare organizations. I’m your host, Kevin Chmura, CEO of Panacea Healthcare Solutions. In this follow-up episode, we’ll continue our conversation with Panacea’s policy expert, Brian Herdman, about Medicaid funding, a critical issue for hospitals and healthcare providers, and take a closer look at how the latest developments in Congress and the administration could impact your bottom line. We’ll also revisit some of the practical steps you should be thinking about today to strengthen your organization’s financial position now that we’ve seen how these policy issues have unfolded. So Brian, welcome back to the podcast. Brian Herdman Great to be here. Kevin Chmura Great to have you back. So, Brian, the One Big Beautiful Bill Act, the OBBBA has now been signed into law and we did a podcast on this topic in March, at which point we were really looking at the versions of the bill that were being kicked around. We were really probably going more off of what we were seeing in the press, in the media, and less what we really knew. Now we’re getting a real look at it. You’ve had an opportunity to spend some time with the text and do your analysis. You are by far our best regulatory expert here at Panacea, so interested in in what you’re saying now, we can spend a lot of time going through the individual provisions as they relate to Medicaid and those things that will be deeply impactful. If we went through all of them, this would be a three hour podcast and I think we lose a lot of the audience. I thought maybe what would be better for everybody, given your expertise in this area? Probably crafting it a little to our target audience, which is probably mostly hospitals and health systems, wondering if you might just spend some time talking about those provisions and those elements that you’re paying the most attention to, the things that you think will be most impactful. And maybe we just take the conversation from there. Brian Herdman Sure. Sure, Kevin. So, you know, after all that back and forth and all those, you know, 4th of July deadline to get the bill passed and whatnot, there is a lot of, you know, what’s going to stay in, what’s not going to stay in between the House and Senate reconciliation process. And now that that has shook out, you know, as I’m looking at the Medicaid specific provisions, because I think that’s where the big change is going to be for our clients, on that Medicaid provisions, you know, there’s kind of two kind of two way, two sets of issues our clients are going to have to look at, you know, the things are going to affect which specific claims are going to be eligible for Medicaid and at what amount. And just generally speaking, the environment that the state, that the provider operates in the state with the state’s Medicaid program, what’s happening with FMAP, what’s happening with state directed payments and how is that going to all unfold? So as I’m looking at those two kind of main themes, you know, what’s happening like, you know, soon what’s happening soon-ish and then, you know, what’s kind of pushed out far ahead. And when I look at the things that are coming up soon, it’s not anything that’s like, you know, hair on fire, oh, my gosh, we have to do a lot of things differently. There was that immediate elimination of some moratorium on some things that would get you streamline applications into Medicaid. That’s going away. And, you know, there is that reduction in FMAP percentage to states when they have done that expansion. But, you know, on the margins, none of those things are going to be a dramatic change to how our clients, you know, get how many of those claims go through and how much they really get paid by the state. When you really start to see that happen is around January 2027. That’s when we’ll start to see a lot of ...
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19 mins