This event has been approved for 1.0 ACHE Qualifying (self-reported) Education Credits.

Medicaid provider taxes have long served as a foundational state financing mechanism used to support Medicaid payment levels and leverage federal matching funds. These taxes are state-designed and may apply to different provider classes, including hospitals, nursing facilities, managed care organizations, and in some states, physician services or specialty physician groups. Recent provisions within the One Big Beautiful Bill (OBBB) propose new restrictions and phased limitations on provider taxes, signaling a major shift in how states may fund their Medicaid programs.

This session will explain how provider taxes function, why policymakers view certain financing arrangements as controversial, and how proposed OBBB changes could affect hospital reimbursement, supplemental and directed payment programs, and state budget flexibility. Particular attention will be given to the potential indirect effects on physicians and physician groups, even in states where they do not directly pay provider taxes, such as pressure on Medicaid fee schedules and hospital-supported clinical services. Participants will gain practical guidance for assessing organizational exposure, engaging in state-level discussions, and planning for evolving Medicaid financing models.

Presenter: Dr. Cristian H Lieneck
School Director-Assoc Professor at School of Health Administration, College of Health Professions
Texas State University

Dr. Cristian H. Lieneck is the Director of the School of Health Administration at Texas State University, where he has spent over 15 years preparing future healthcare leaders.

His career began as an emergency medical technician and as a U.S. Army Medical Service Corps officer, where he earned multiple recognitions for his leadership related to medical evacuation missions and follow-on senior-executive military health service operations, including being awarded the Meritorious Service Medal (MSM) upon completion of his active duty military service. He has over a decade follow-on experience leading medical group practices/outpatient service organizations across Texas, specializing in financial management and health service marketing initiatives. His prior experience includes leadership positions at Austin Radiological Association (ARA), the Texas Medicaid Community Assistance Support Program, and serving as the practice administrator of a physiatry/pain management medical group consisting of an outpatient surgery suite in Austin and multiple clinics across Central Texas.

Today, Dr. Lieneck is well known for strengthening the professional development of healthcare leaders nationwide. He is a Fellow of the American College of Healthcare Executives (ACHE), the Academy for Healthcare Management (AHM), the Health Information Management Systems Society (HIMSS) and the Medical Group Management Association(MGMA), and actively mentors early-, mid-, and senior-level healthcare administrators across all sectors of the industry. He was previously elected and served as an ACHE Regent for Central and South Texas (District 4),where he supported executives through education, networking, and leadership programming. He continues to teach financial management, information technology/management, and the general business domain modules for the ACHE Board of Governors FACHE exam review course, assisting hundreds of healthcare leaders with their professional development goals and is a very active ACHE CHOICE program faculty member – speaking and conducting educational workshops to hospitals and healthcare systems regularly. Simultaneously serving as Texas MGMA’s Forum Representative, he builds connections across practice management leaders and contributes to advancing the profession of medical group practice management, assisting outpatient administration leaders with the skills needed to succeed through lectures and conference presentations.

Dr. Lieneck continues to research and publish on healthcare finance, practice management, and value-based leadership while serving on local, state, and national committees. His recently published textbook,” Healthcare Financial Accounting: A Guide for Leaders” in 2022 has been adopted by multiple graduate and undergraduate programs in higher education and is even offered as a primary textbook with his new online course (“CODE BLUE on your Balance Sheet: A Healthcare Financial Accounting Refresher”) for non-student healthcare leaders seeking additional learning support though the Texas State University Continuing Education program. His work reflects a commitment to both academic excellence and applied leadership development, ensuring healthcare executives are prepared to meet the challenges of a rapidly changing industry.

Known for incorporating his bluegrass mandolin playing in his teaching sessions, he also enjoys spending time with his family and traveling.

Research Interests:

Healthcare value (directed towards finance and marketing perspectives), practice administration (ambulatory care), and healthcare administration andragogy.