[NYAPRS Enews] DHPR: Bush Would Accept Delay on 2 Medicaid Regs, Not Case Management

[Harvey Rosenthal]

NYAPRS Note: On the heels of the House's overwhelming passage of
legislation to delay 7 proposed Medicaid regulatory changes and a
willingness in the Senate to do the same, the Bush Administration is now
offering to accept delays on two of the regulations (not the case
management and rehabilitation regulations.) With votes to override
potential Presidential vetoes in the House and possibly the Senate, it
appears that Congress, the nation's Governors and the advocates will
continue to push for a full delay into the next Administration. 

 

HHS Secretary Leavitt Says Bush Administration Would Accept Short-Term
Moratorium on Two New Medicaid Regulations, While Five Others Would Take
Effect

Kaiser Daily Health Policy Report   April 30, 2008

      

HHS Secretary Mike Leavitt on Tuesday said that the Bush administration
would accept a short-term moratorium on two of seven proposed Medicaid
regulations to give lawmakers time to reach an agreement on the changes,
CongressDaily reports (Johnson, CongressDaily, 4/29). Under the
regulations, states could not use federal Medicaid funds to help pay for
physician training. The regulations also would place new limits on
Medicaid reimbursements to hospitals and nursing homes operated by state
and local governments and limit coverage of rehabilitation services for
individuals with disabilities and mental illnesses. In addition, the
bill would provide $25 million annually for efforts to fight Medicaid
fraud (Kaiser Daily Health Policy Report, 4/25). 

 

Leavitt said, "We're trying to put a package together where the five
would remain and we would extend [graduate medical education funding]
and [intergovernmental transfers to public hospitals] for a period where
we tried to find a solution," adding, "We would defer the implementation
until August, and if we're not able to do that, it would be deferred
until March." Leavitt reiterated President Bush's intention to veto
legislation (HR 5613) that would place a moratorium on all seven rules,
saying that there are "ambiguities in the law that are being exploited
in many ways" and that "need to be fixed" (CongressDaily, 4/29). 

 

Legislation 

Leavitt's statements come after the House last week approved the bill by
a veto-proof majority. The legislation would block the regulations from
taking effect until April 1, 2009. Senate Majority Leader Harry Reid
(D-Nev.) on Tuesday tried to pass the bill by voice vote, but Sen. Tom
Coburn (R-Okla.) objected. Before the bill can advance further, Reid
will have to file a cloture petition, which "would consume valuable
Senate floor time that Reid needs for other bills," according to CQ
Today (Wayne, CQ Today, 4/29). Senate Finance Committee Chair Max Baucus
(D-Mont.) on Tuesday said he wants to attach the legislation to the Iraq
war supplemental spending bill.

 

Meanwhile, Senate Minority Whip Jon Kyl (R-Ariz.) on Tuesday said he
supports a deal with the administration, saying, "They've singled out
the two most controversial rules. I don't support a moratorium for
graduate medical education, for example, so I'm glad they're willing to
negotiate on that," adding, "I think the [Bush administration] proposal
is reasonable, and hopefully it will lead the Congress to negotiate
rather than trying to pass some bill out of the Congress"
(CongressDaily, 4/29). 

------------------

 

Senate Fast-Tracks Medicaid Bill That Would Delay New Rules; CMS Defends
Rules, Willing To Talk

Medical News Today   April 28, 2008   

Senate Majority Leader Harry Reid (D-Nev.) on Thursday granted
fast-track status to legislation (HR 5613
<http://thomas.loc.gov/cgi-bin/query/z?c110:H.R.5613:> ) that would
block for one year seven new Medicaid regulations, the Wall Street
Journal reports (Zhang, Wall Street Journal, 4/25). The legislation
would delay implementation of the regulations until April 1, 2009. Under
the regulations, proposed by the Bush administration, states could not
use federal Medicaid funds to help pay for physician training. The
regulations also would place new limits on Medicaid reimbursements to
hospitals and nursing homes operated by state and local governments and
limit coverage of rehabilitation services for individuals with
disabilities and mental illnesses. In addition, the bill would provide
$25 million annually for efforts to fight Medicaid fraud (Kaiser Daily
Health Policy Report
<http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=51729> ,
4/24).

The bill will bypass the Senate Finance Committee
<http://www.senate.gov/~finance>  and head straight to the Senate floor
as early as next week, the Journal reports. The bill passed the House on
Wednesday with more than a veto-proof majority. Sen. Charles Schumer
(D-N.Y.) said, "These rules are unwise, unvetted and unrealistic,"
adding, "The Senate is moving closer to joining with the House to make
sure these rules never see the light of day." However, some Senate
Republicans "are preparing for a fight by circulating a letter to
Minority Leader Mitch McConnell (Ky.) to reject" the bill, according to
the Journal (Wall Street Journal, 4/25).

Meanwhile, House Democratic leaders also could include language to block
the Medicaid regulations in a tentative second economic stimulus
package, the AP/Philadelphia Inquirer
<http://www.philly.com/inquirer/world_us/18167249.html>  reports
(Taylor, AP/Philadelphia Inquirer, 4/25). 

 

CMS Defends Rules 
At a meeting of the National Conference of State Legislatures
<http://www.ncsl.org/>  on Thursday, CMS <http://www.cms.hhs.gov/>
Acting Administrator Kerry Weems defended the new regulations but said
that the administration would be willing to discuss them with lawmakers,
CongressDaily reports. Weems also said agency officials are urging
senators to vote against the House bill. "If you really are serious
about good fiscal policy, you've got to draw the line somewhere," Weems
said, adding, "These regulations draw that line." However, Weems said
the administration is willing to discuss them "if that looked like a
fruitful route" (Johnson, CongressDaily, 4/25). 

According to sources on Capitol Hill, the administration would be
willing to negotiate the rules on graduate medical education and
"intergovernmental transfer" payments, which are "extremely sensitive
politically because they in part have funded safety-net programs for
poor patients," CQ HealthBeat
<http://www.cq.com/corp/show.do?page=products_cqhealthbeat>  reports.
Weems declined to discuss which regulations the administration would
consider changing. A congressional aide said that, if the House bill
lacks enough support in the Senate to make it veto-proof, the
administration will push for the limited moratorium strategy (Reichard,
CQ HealthBeat, 4/24).

 

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