Senate GOP Seeks To Remove Provisions To Delay Medicaid Regulations From War Spending Bill

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Public Health;  Women's Health / Gynecology
Article Date: 13 May 2008 - 6:00 PST

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Some Senate Republicans are pushing to remove provisions in the supplemental war spending measure that would prevent seven new Medicaid regulations from taking effect until April 1, 2009, CQ Today reports. Republicans also are attempting to remove a provision in the bill that would ban physician-owned specialty hospitals from receiving Medicare payments. The House approved the delay in Medicaid legislation (HR 5613) approved last month.

Sen. Charles Grassley (R-Iowa), ranking Republican on the Senate Finance Committee, on Thursday sent a letter to Senate appropriators asking that the two provisions be removed from the measure. Grassley in the letter said that Medicare and Medicaid are a "basic part of the jurisdiction of the Finance Committee." Grassley sent copies of the letter to Finance Committee Chair Max Baucus (D-Mont.); Senate Appropriations Committee Chair Robert Byrd (D-W.Va.); and Sen. Thad Cochran (R-Miss.), ranking member of the Appropriations Committee.

Baucus spokesperson Carol Guthrie said, "Sen. Baucus has said that in light of the fact that efforts to move legislation stopping these bad Medicaid (regulations) from being implemented have been blocked, the supplemental funding bill is a viable vehicle for moving them forward." Byrd had not responded to the letter as of Friday, but Byrd spokesperson Jesse Jacobs said the provisions have support from Democratic leaders in the Senate. Jacobs added that the provisions are expected to be included in the House version of the war funding bill.

Cochran spokesperson Margaret McPhillips said the senator is supporting Grassley, adding that Cochran "was certainly not consulted" when the provisions were added to the spending bill. McPhillips said that the provisions "don't belong on a supplemental appropriations bill, particularly if there is to be no opportunity for amendments on the House or Senate floor, and no conference committee" (Armstrong, CQ Today, 5/9).

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; reduce federal Medicaid reimbursement for students at teaching hospitals; and limit taxes some states charge health providers. HHS Secretary Mike Leavitt has said that if Congress allows the rules on reimbursement to public hospitals and the reduction of reimbursement to teaching hospitals, the Bush administration would be willing to postpone implementation of the other five rules (Daily Women's Health Policy Report, 5/7).

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