Modern Physician reports that HHS is getting serious about cutting off those "accounting games" that enable states like New York (but by no means only New York) to get so much extra cash out of Medicaid. While this might be a great idea in theory, you can expect that Congressional delegations from several states, not to mention the Governors, will go ballistic when they figure out what that might mean for their budgets. It’s tantamount to going to the block grant proposal that we’ve heard before, and that was discussed on THCB on Inauguration day, which now seems quite a while back.