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May 30, 2008

Urge Congress to Retain Medicaid Rules Moratorium in Supplemental Bill

The U.S. Senate voted 75 to 22 on May 22 to approve a domestic spending amendment that includes a moratorium on seven Medicaid regulations and a ban on self-referral to new physician-owned hospitals, as part of an Iraq war spending bill. The moratorium on the Medicaid rules would extend until April 1, 2009. The Senate version of the bill now goes to the House and could go to the President in June.  The President has threatened a veto.

Earlier, the U.S. House voted 256 to 166 to attach an amendment that includes HR5613, Protecting the Medicaid Safety Net Act of 2008, to the Iraq supplemental appropriations bill, delaying the implementation of the Medicaid rules until April 1, 2009. But the House did not include a war spending amendment.

IHA thanks the members of the Illinois Congressional Delegation for their support for the Medicaid moratorium in the Iraq war spending bills, including U.S. Senator Richard Durbin whose leadership was instrumental to the Senate action.

But we need to continue urging Congress to ensure that the moratorium is retained in the final Iraq war supplemental spending bill that is finally signed into law. To send an email to your members of Congress, click here. 

Meanwhile, the Bush Administration announced that it will voluntarily extend the moratorium on two of the Medicaid rules - on intergovernmental transfers (IGT) certified public expenditures and graduate medical education (GME) until Aug. 1.

Separately, a federal judge issued a ruling on May 23, siding with AHA and other organizations and ordering the U.S. Department of Health and Human Services to vacate one of the Medicaid rules.

Moratorium on CMS Medicaid Rules
Federal advocacy efforts have been intensely targeted at enlisting the help of Congress to extend a moratorium to block CMS rules that would be disastrous for the Medicaid program and the patients our hospitals serve. The current moratorium is scheduled to expire on May 25, and, if implemented these rules are estimated to cut $50 billion from the Medicaid program over the next five years, including a $2.5 billion reduction to Illinois.

HR5613 and its companion bill, S2819 would impose until April 1, 2009 a moratorium on 7 onerous Medicaid rules, including ones that would limit payments to public providers and impact intergovernmental transfers (IGT), and eliminate federal Medicaid payments for graduate medical education (GME). In addition the rules would eliminate or restrict payments for outpatient hospital services; provider tax definitions; certain rehabilitation services; transportation/administrative services for certain children under Medicaid; and targeted case management services that enable certain disabled people to remain in the community.

In addition, eliminating federal GME payments and reducing payments for outpatient services will adversely impact upper payment limits (UPL). Lower UPLs would restrict and reduce payments that can be made to Illinois hospitals under the Illinois Hospital Assessment Program – a statewide program that for several years has provided vital support for Illinois’ health care delivery system.