Lawmakers and healthcare trade groups reacted with outrage Friday as Bush administration officials issued rules to curb states from collecting higher federal Medicaid payments just hours after Congress told the officials not to do so.
The CMS took the unusual step Friday of releasing a final rule that limits the states use of intergovernmental transfers and alters the upper payment limit even though not 24 hours earlier Congress said the agency could not immediately implement the regulation.
On the surface, the rule restates that only units of government are able to participate in the financing of the nonfederal share of Medicaid payments; establishes minimum requirements documenting cost when using a certified public expenditure; and limits Medicaid reimbursement for public facilities operated by state and local governments to the individuals cost.
But a provision in the supplemental funding bill, which passed the House and Senate on Thursday night and is expected to be signed later Friday by President Bush, effectively blocks the CMS from taking any action on the rule for at least a year.
The push by the CMS to publicly release the rule Friday in light of the Thursday vote sparked a firestorm on Capitol Hill and throughout several industry associationsalmost all of which originally protested the rule. Rick Pollack, executive vice president at the American Hospital Association, called the move inexplicable.
But the CMS defended the release, adding that the agency would comply with the statute approved Thursday. In the interests of transparency, we wanted interested parties and the public to see the decisions that we made in responding to public comments on the proposed rule, CMS spokesman Jeff Nelligan said in a statement. This way, the public is able to see how we responded to the comments we received and will also see that we are still soliciting comments on the provision of the rule related to the definition of governmental entities.
Meanwhile, the $120 billion supplemental funding bill also contains provisions to fund the State Childrens Health Insurance Program shortfall for the balance of fiscal 2007 and implements a one-year moratorium on a proposed rule by the CMS that would eliminate graduate medical education under the Medicaid program. -- by Matthew DoBias