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Rep. Williams Introduces Legislation to Delay MFAR Implementation

Jul 13, 2020
Press Release

WASHINGTON, D.C. Congressman Roger Williams (R-TX-25) and Congresswoman Eddie Bernice Johnson (D-TX-30) today introduced the MFAR Transparency Act to delay the implementation of the Medicaid Fiscal Accountability Rule (MFAR) and direct the U.S. Government Accountability Office (GAO) to conduct a study on the financial impacts on each state. The bill would also identify necessary information for reporting to comply with laws and regulations pertaining to the funding of Medicaid payments.

“Blindly implementing the MFAR would lead to devastating hospital closures and disproportionately harmful outcomes in rural and underserved regions of Texas. The financial impacts would cause local governments to increase taxes in order to make up for lost dollars, resulting in a reduction of our ability to provide essential health services for Texans,” said Congressman Williams. “By delaying the rule and thoroughly analyzing the consequences of its implementation, we will be able to ensure patients continue receiving the highest quality of care possible. I’m proud to lead this effort on behalf of our Texas health systems and the patients they serve.”

Additionally, the bill would keep the Centers for Medicare and Medicaid Services (CMS) from finalizing MFAR without future congressional authorization, but still allow them to implement provisions to improve accounting, reporting and transparency of Medicaid payments. In March, Congressman Williams and members of the Texas delegation sent a letter to CMS Administrator Seema Verma urging the delayed implementation and restructuring of MFAR.

Quotes of support from Texas-based health systems:

Ascension Texas

“For over 118 years, Ascension Texas has provided quality healthcare in Central Texas. This legislation will analyze the economic impact of MFAR, protect funding for our community’s healthcare needs, and ensure we have the sustainability to serve our neighbors for another 100 years,” said Andy Davis, President & Chief Executive Officer, Ascension Texas.

Goodall-Witcher Hospital in Clifton

“Having a better handle on the impact of curtailing hospital supplemental payments as proposed by CMS is absolutely critical. In a state like Texas that has not expanded Medicaid and with high levels of uninsured, these payments keep hospital doors, especially rural hospitals,  open. Representative Williams is absolutely correct to insist on an impact study rather than CMS blindly implementing changes without fully knowing the impact,” said Adam Willmann, CEO of Goodall-Witcher Clifton and Board Chairman of the Texas Organization of Rural & Community Hospitals.

Baylor Scott & White

“We applaud the leadership of Congressman Roger Williams and Congresswoman Eddie Bernice Johnson to address a very important issue during this COVID-19 crisis. As the healthcare industry and other industries across the nation are suffering historic financial loss, it is not the time to remove approved funding structures that draw down Medicaid dollars. As need rises on the heels of this crisis, more support for Medicaid and the uninsured is needed. The MFAR Transparency Act would require an evaluation of the proposal, a prudent first step to understand its impact.”

Texas Hospital Association

“The proposed rule would devastate Texas’ already fragile hospital and health care infrastructure and cut critically needed access to health care services,” said Ted Shaw, Texas Hospital Association President/CEO. “Texas hospitals applaud Rep. Williams’ leadership to delay finalization of MFAR and fully assess its impact on patients, providers and state economies.”

Texas Organization of Rural & Community Hospitals

“The rural hospitals of Texas appreciate Representative Williams for standing up to protect them. The proposed CMS regulation appears to have a very negative impact on all hospitals and especially those in rural areas. This bill will allow for decisions to be made based on hard data rather than blindly trying to save some money at the expense of Texas and hospitals, which would in turn reduce access to care,” said Don McBeath with the Texas Organization of Rural & Community Hospitals.

Texas Council of Community Centers

“The Texas Council of Community Centers is grateful to Congressman Williams for his leadership in filing the MFAR Transparency Act. As units of local government, Texas Community Mental Health Centers (CMHCs) serve all 254 Texas counties and leverage funds through the state’s 1115 Transformation Waiver supplemental payment program to increase access to services for more than 220,000 Texans with serious mental illness. We support Congressman Williams’ effort to mitigate the detrimental impact of the CMS proposed Medicaid Fiscal Accountability Rule (MFAR) on this important resource for people with serious mental illness,” said Danette Castle, Chief Executive Officer for the Texas Council of Community Centers, the state association representing the 39 Community Mental Health & Intellectual Disability Centers of Texas. 


Congressman Roger Williams represents the 25th Congressional District of Texas and serves as a member of the House Committee on Financial Services.