WASHINGTON WIRE
April 4, 2008
Issue 164
House Subcommittee Examines Medicaid Regulations, Moratoria Legislation
Chairman Baucus to Bring Medicare Bill Directly to Senate Floor
CMS Releases New Standards for Dialysis Centers
Hearings
Top Story
House Subcommittee Examines Medicaid Regulations, Moratoria Legislation
During a House Energy and Commerce Health Subcommittee hearing this week, witnesses urged Members to enact legislation to delay the implementation of seven Medicaid regulations, which they claim would significantly impact access to care for many Medicaid recipients.
The Centers for Medicare and Medicaid (CMS) have issued a series of proposed or final Medicaid rules addressing a number of issues including rehabilitative and school-based services, targeted-case management, hospital outpatient payments, provider taxes, and graduate medical education. Legislation introduced by Energy and Commerce Committee Chairman, John Dingell (D-MI), and Congressman Patrick Murphy (R-PA) would place moratoria on the seven regulations until April, 2009.
Witnesses representing physicians, educators, and hospital administrators all testified that the individual and cumulative impact of the regulations would be devastating to states, recipients and the providers who serve them. A recent House Oversight Committee report estimates that the regulations could cost states up to $50 billion.
However, Dennis Smith, the director of Medicaid at CMS, stated that the regulations are intended to curb abuses in the program, stating that many Medicaid programs are inappropriately drawing down federal funds and claiming services that should not be covered by Medicaid. James Cosgrove, Acting Director of the Government Accountability Office (GAO), stated that the agency has documented methods used to inflate the federal payments drawn down by the states. But, when questioned by Chairman Dingell, Mr. Cosgrove ceded that his agency had not studied or made any specific recommendations with regard to the regulations being addressed in the legislation.
On Thursday, Senators Rockefeller (D-MV),Snowe (R-ME), and Kennedy (D-MA) introduced legislation in the Senate that would implement a year-long moratorium on the same seven regulations. The Senate bill would also overturn CMS guidance issued last August regarding the State Children's Health Insurance Program (SCHIP) and increase Medicaid funding to states.
Health Care News
Chairman Baucus to Bring Medicare Bill Directly to Senate Floor
It appears that the Senate Finance Committee Chairman, Max Baucus (D-MT), will bring Medicare physician payment legislation directly to the Senate floor, bypassing what would be a difficult Committee mark-up.
Under Medicare, physicians are scheduled to receive a 10% payment cut in July, followed by a 15% cut in January as a result of the current sustainable growth rate (SGR) formula and a series of short-term legislative fixes. It has been largely assumed that Congress would legislate another patch to prevent the cuts from taking effect.
Senate Finance Committee Member, Debbie Stabenow (D-MI), has introduced legislation that would delay the pending 10% physician pay cut for 18 months, extend the 0.5% update implemented in December until the end of this year, and boost the update to 1.8% in 2009. While the legislation is supported by physician groups such as the American Medical Association (AMA), Chairman Baucus has indicated he will be assembling his own Medicare package which will likely include an 18-month fix at a cost of roughly $8 billion over five years.
A Medicare bill is not only important to the physician community, it is also being eyed as a target by other stakeholders as a potential vehicle for other healthcare priorities including an extension of the Medicare therapy cap exceptions process and moratoria on unpopular Medicaid regulations.
CMS Releases New Standards for Dialysis Centers
On Thursday, the Centers for Medicare and Medicaid Services (CMS) released a final rule outlining new quality standards for kidney dialysis centers under Medicare.
One of the provisions under the rule would require facilities to develop quality assessment and performance improvement programs to track patient outcomes. CMS stated that the rule would also remove current "burdensome" requirements for facilities including employing a medical records supervisor and requiring a separate long-term care program.
The rule is expected to be published in the April 15th Federal Register.
Upcoming Events
Hearings
Wednesday, April 9, 2008
Making VA Health Facilities Workplaces of Choice
Senate Veterans' Affairs Committee
9:30 a.m., 418 Russell
Global Warming and Public Health
House Select Energy Independence and Global Warming Committee
10 a.m., TBA
SCHIP Directive
Senate Finance Committee
2:30 p.m., 215 Dirksen
Thursday, April 10, 2008
Climate Change and Health
Senate Health, Education, Labor and Pensions Committee
10 a.m., 430 Dirksen
Family Medical Leave Act
House Education and Labor - Subcommittee on Workforce Protections
10 a.m., 2175 Rayburn
Veterans' Health Bills
House Veterans' Affairs - Subcommittee on Health
2 p.m., 334 Cannon
For More Information
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