March 25, 2008
Ask Your Representative to Halt Medicaid Rules
Cosponsors Needed for the
Protecting Medicaid Safety Net Act (H.R. 5613)
Background
The Centers for Medicare and Medicaid Services (CMS) has issued seven Medicaid regulations that will significantly cut Medicaid payments for social work and other services to vulnerable Medicaid clients. The regulations are an attempt to implement Medicaid cuts proposed in the Bush Administration’s Fiscal Year 2008 Budget.
Recently, Representatives John Dingell (D-MI) and Timothy Murphy (R-PA) introduced “Protecting the Medicaid Safety Net Act of 2008” (H.R. 5613) to delay until April 9, 2009 implementation of these seven cost-cutting Medicaid regulations. The bill has been referred to the House Energy and Commerce Committee, which may consider it as early as April 1. Similar legislation will be introduced shortly in the Senate.
The seven rules reduce Medicaid recipients' access to rehabilitative services, targeted case management, school-based transportation and outreach services, and hospital clinic services. The regulations have drawn strong criticism from social workers across the country and a range of other stakeholders, including organizations representing people with disabilities, children and families, hospitals, educators, providers and state Medicaid directors. H.R. 5613 would impose a moratorium on all seven of the detrimental rules. Summarized below are three of those rules most frequently cited by social workers as detrimental to the clients they serve:
Regulation |
5 Year Cost |
Status |
Description |
Changes could impact |
Case Management and Targeted Case Management (TCM) |
$1.3 billion cut |
Interim final: December 2007
Became effective on March 3, 2008 |
Restricts coverage of transitional case management. See Comments to CMS |
· Transition from institutional care to the community
· A wide range of social work services |
Rehabilitation Services (Rehab) Option |
$2.3 billion cut |
Proposed: August 2007
Moratorium through June 2008 |
Narrows scope of rehab services. See Comments to CMS |
· Day habilitation such as skills training and communications skills training |
School-Based Administration and Transportation Services |
$3.6 billion cut |
Final: December 2007
Moratorium through June 2008 |
Prohibits all Medicaid payments for school-based administration and most transportation services. See Comments to CMS |
· Specialized transportation
· Occupational therapy
· Physical therapy
· Speech/language therapy |
How much will the Medicaid regulations cost your state?
Congressional staff have prepared an estimate of the impact of these rules for your state at: http://oversight.house.gov/features/medicaid08/ Fortunately, Congress has the authority to delay the implementation of these regulations through a legally authorized postponement known as a moratorium. A moratorium gives Congress time to review the regulations closely and propose needed revisions through legislation.
Status
House Energy and Commerce Committee Chairman John Dingell (D-MI) and Rep. Tim Murphy (R-PA) introduced the Protecting Medicaid Safety Net Act of 2008 (HR 5613) on March 13. The bill would provide a 1 year moratorium on the regulations, prohibiting CMS from taking action to implement them until April of 2009. A Senate companion bill is expected to be introduced soon.
Take Action
Please contact your Representative and him/her to pass HR 5613. NASW members may use our website to send a sample message electronically to their Representative, by visiting
http://capwiz.com/socialworkers/issues/alert/?alertid=11190396&PROCESS=Take+Action
For background information, see the comments NASW submitted with its coalition partners to CMS (Rehab option comments to CMS; School-based transportation and administration comments to CMS; and Targeted case management comments to CMS)
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