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GAO Report: Medicaid Demonstration Waiver Approval Process Raises Cost Concerns and Lacks Transparency
U.S. Government Accountability Office [GAO] Link to more items from this source
July 18, 2013
60 pages. "The [HHS] budget neutrality policy and process did not provide assurances that all recently approved demonstrations will be budget neutral. For 4 of 10 demonstrations GAO reviewed, HHS approved spending limits that were based on assumptions of cost growth that were higher than its benchmark rates, and that, in some cases, included costs states never incurred in their base year spending. HHS's benchmark growth rates are the lower of the state's recent growth rates or projections for Medicaid program growth nationwide.... For 6 other demonstrations, the approved spending limits reflected the states' actual historical costs or criteria that were specified in law, which HHS followed." [GAO-13-384, published Jun. 25, 2013, released Jul. 18, 2013]

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