MACPAC is a non-partisan legislative branch agency that provides policy and data analysis. Their purpose is to make reasonable nonpartisan recommendations to Congress on Medicaid programs. They issued a report finding that without increased transparency in how nursing homes spend Medicaid dollars, it could not determine the actual costs of providing care. MACPAC was not able to determine the adequacy of Medicaid payments to nursing homes.
The MACPAC report stated that self-reported costs on Medicaid cost reports are insufficient to follow the money. States have varying definitions of what services a nursing home can be compensated for providing. Additionally, the report noted related party transactions “artificially inflate the costs reported on Medicare cost reports.”
Despite the lack of supporting evidence, the industry claims Medicaid reimbursement is inadequate. Transparency in cost and revenue would help but the industry refuses to disclose where all the money goes. Advocates have repeatedly called for increased transparency in how current Medicare and Medicaid dollars are spent before more public money is given to nursing homes. Federal and state governments must require increased disclosure of related party transactions and other accounting hijinks nursing homes use to hide how they spend taxpayer dollars.