As published by the Centers for Medicare & Medicaid Services (CMS), this change is effective only for the fourth quarter of federal fiscal year 2009 and the first quarter of federal fiscal year 2010. Affected claims will be reprocessed, and payments will be adjusted accordingly. No action on the part of the provider is necessary.

FMAP is the federal government’s contribution to states for Medicaid expenditures and is used for Medicaid fee-for-service and managed care. The FMAP change affects only providers that certify expenses and are paid only the federal share of their claims.

Effective for dates of service on or after October 1, 2009, the Enhanced Federal Medical Assistance Percentage (EFMAP) rate will change from 71.61 percent to 71.11 percent. 

For more information, call the TMHP Contact Center at 1-800-925-9126.