House Subcommittee Approves Measure Blocking Seven New Medicaid Rules

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Women's Health / Gynecology
Article Date: 11 Apr 2008 - 6:00 PST

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The House Energy and Commerce Committee Subcommittee on Health on Wednesday by voice vote approved a measure (HR 5613) that would impose a moratorium on seven new Medicaid regulations for one year, CQ Today reports. The measure passed after the committee adopted an amendment offered by the Energy and Commerce Chair John Dingell (D-Mich.) that aims to ensure that only the seven new regulations would be blocked and that the bill would not apply to any future regulations. According to CQ Today, the amendment "embodied a compromise" with Republicans, who had expressed concern about the overall measure but generally support it.

The Medicaid regulations could reduce health care coverage for pregnant women, low-income children, nursing home residents and other groups. The seven rule changes at issue aim to restrict services covered by some states' case management plans; limit Medicaid reimbursement to public hospitals; narrow federal Medicaid reimbursement eligibility for outpatient hospital services; bar federal reimbursement for transportation to school and school-based care for Medicaid-eligible children; restrict the types of "rehabilitative" services covered by federal funding; cut federal Medicaid reimbursement for students at teaching hospitals; and limit taxes some states charge health providers.

The Congressional Budget Office estimates that the rule changes would save Medicaid about $17.8 billion over five years. CBO estimates the measure would cost about $1.65 billion because CBO already has projected savings from the rule changes over the next year (CQ Today, 4/9). The bill requires HHS to submit a report to Congress that identifies the prevalence of fraud and abuse in the areas the regulation changes seek to remedy, explains how the rules would address those issues and cites the legal authority for the rule changes, BNA reports. HHS also would be required to hire an independent contractor to evaluate the assess the impact of the rule changes on each state, as well as identify the prevalence of fraud and abuse and strategies that are in place to deal with those issues (BNA, 4/10). Lawmakers on the panel also added a provision to the measure that would allocate an additional $25 million annually to HHS to reduce Medicaid fraud and abuse (Zhang, Wall Street Journal, 4/10).

Outlook

Rep. Frank Pallone (D-N.J.), chair of the health subcommittee, said he wants the full committee to consider the bill next week so it can quickly move to the House floor. According to CongressDaily, the measure could be passed as stand-alone legislation or could be attached to an emergency Iraq spending measure to expedite its approval (Johnson, CongressDaily, 4/9).

According to CQ Today, Bush administration officials previously said President Bush would likely veto the measure, but if Republicans in both the House and Senate support it, a veto could be overridden by a two-thirds vote in each chamber (CQ Today, 4/9). Rep. Joe Barton (R-Texas) said he is "reasonably confident" that Bush will not veto the measure because it emphasizes reducing Medicaid fraud.

Mary Kahn, a spokesperson for Centers for Medicare and Medicaid Services, said the administration "has and will continue to oppose any moratorium on enactment" of the regulations (Wall Street Journal, 4/10). Rep. Michael Burgess (R-Texas) said members of both parties are "in agreement" that efforts to overhaul Medicaid are "far from concluded," adding that he would not attempt to block Dingell's measure "in the spirit of compromise" (CongressDaily, 4/9).

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