CMS proposes rules for provider-tax limits, with comments due September 21
Issue
Federal law already caps each state provider-tax class at its July 4, 2025 rate starting October 1, 2026, and CMS has proposed how to carry that out. In expansion states, most classes then drop to the lower of that cap or 5.5% in fiscal year 2028, falling to 3.5% by 2032.
Comments are due September 21, 2026.
Key points
- Separate the layers: the class-specific ceilings and expansion-state phase-down are enacted law; CMS's calculation, reporting, 75/75-test, and oversight mechanics are still proposed.
- Each state's result depends on its July 4, 2025 tax and class, and nursing-facility and ICF/IID classes stay out of the phase-down.
- Public-comment privacy boundary: never place patient, applicant, employee, or confidential center information in FQHC Talent; CMS warns that information submitted to the docket may become public.
Sources for this story
CMS / official Federal Register PDF (91 FR 46562; CMS-2452-P)Part of
- Medicaid financing and eligibility operations
Provider taxes and state-directed payments
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FQHC Talent. (2026, July 23). CMS proposes rules for provider-tax limits, with comments due September 21. Source: CMS / official Federal Register PDF (91 FR 46562; CMS-2452-P). Retrieved November 11, 2026, from https://www.fqhctalent.com/intel/cms-provider-tax-hold-harmless-71115-proposed-rule-july-2026