CMS officials declined to respond directly to allegations in the state’s pending litigation.
“While we can’t comment on pending litigation, CMS sent the following letter to Maine state officials last week indicating that we will review this matter carefully and render a decision as soon as our review is complete,” an e-mailed statement from the agency said.
Maine has sought federal approval to make changes in its Medicaid rules that would decrease spending by $20 million in the fiscal year starting Oct. 1 by making it more difficult to qualify for coverage, though state officials say their system would still exceed federal minimums and national norms.
MaineCare is budgeted to spend $879 million during the year, or 34% of the state budget. State officials trimmed $20 million from the program to balance its upcoming budget by changing the way three groups of Medicaid recipients qualify for coverage.
The changes would eliminate benefits to about 33,000 people, according to news reports.
A motion for injunctive relief filed with the 1st U.S. Circuit Court of Appeals in Boston on Tuesday says that the state was notified by CMS officials on Aug. 31 that the agency had declined to expedite its review or guarantee that it would approve the changes by Oct. 1. Maine law requires the state to have a balanced budget by Oct. 1.
The petition for review filed by Maine Attorney General William Schneider asks federal judges to either order the CMS to approve the changes or demand that the federal agency cover the costs that the state would incur to cover the Medicaid recipients whose coverage it seeks to end, pending the outcome of the litigation.
The state says the requirement in the reform law that states maintain their current Medicaid coverage rules through 2014 for adults and 2019 for children is likely unconstitutional because they were invalidated by the June Supreme Court ruling that struck down the law’s provision that threatened to take away states’ Medicaid funds if they refuse to expand eligibility requirements.
Maine’s lawsuit says HHS Secretary Kathleen Sebelius told state officials in a letter that the administration believes the Supreme Court decision did not affect the so-called maintenance-of-effort, or MOE, requirement on Medicaid eligibility. However, state officials say the MOE in the reform law was unconstitutional since it was essentially a mandatory extension of an earlier voluntary MOE in the American Recovery and Reinvestment Act of 2009.