The Centers for Medicare and Medicaid Services (CMS) last week issued a proposed Medicaid Fiscal Accountability Regulation that would impact provider assessments and upper payment limit (UPL) programs. CMS is proposing significant changes in the regulations that frame permissible provider taxes and various UPL programs, including new requirements for broad-based and uniform waivers. Massachusetts utilizes both the broad-based and uniform waivers in its nursing facility assessment program. Provider Assessment and UPL programs are a major source of state Medicaid funding for a majority of the states in the nation, including Massachusetts. Mass Senior Care continues to review the proposed rule to determine the impact it will have on members.