Special Medicaid funds help most states but prompt oversight concerns

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Emanuel Medical Center in rural Georgia racks up more than $350,000 a month in losses providing health care for low-income and uninsured patients. But a new state funding proposal could significantly reduce those deficits, not just for the 66-bed Swainsboro facility but for most rural hospitals in Georgia, according to state Medicaid officials.

It’s not Medicaid expansion, which Georgian Republican leaders have rejected. Instead, the state Department of Community Health is using an under-the-radar Medicaid funding opportunity that has been rapidly taken up by more than 35 states — including most of the states that have expanded the government insurance program.

The extra federal money comes through an obscure, complicated mechanism called “directed payments” — available only for states that hire health insurers to deliver services for Medicaid.

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