Health on the Hill from kaisernetwork.org and CQ
CQ Health Beat's Mary Agnes Carey looks at recent activity on the Hill
President Bush's fiscal 2009 budget is expected to include cuts to many federal health care programs, including Medicare and Medicaid. Meanwhile, the Senate Finance Committee is holding hearings into the operations of private fee-for-service plans in Medicare, while House Energy and Commerce subcommittee members have issued subpoenas as part of the panel's investigation into the antibiotic Ketek.
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Read about the Substantive Changes in Federal Medicaid Rules and Anticipated Impact

Fact Sheet

Read the News Release from the Commissioners for Health and Human Services and Education

Federal Medicaid Rules Changes

Medicaid Powerpoint

Read a newspaper article about the changes.

State officials warn of federal aid curbs

By Francis X. Quinn, Associated Press Writer | January 30, 2008

AUGUSTA, Maine --Baldacci administration officials said Wednesday pending federal changes in Medicaid rules could cost the state of Maine $45 million through the next 16 months. They also said community losses, including for nonprofit health care providers and schools, could total $141 million over the same period.

Commissioner Brenda Harvey of the state Department of Health and Human Services said case management services for groups including children in the child protective system would no longer be eligible for federal payment. Harvey also said many rehabilitation services previously covered would no longer receive federal Medicaid funds.

Harvey and state Education Commissioner Susan Gendron briefed reporters and the Legislature's Appropriations Committee on Wednesday and plan to offer similar information via videoconference Thursday to providers and school districts.

A spokeswoman for the Boston regional office of the federal Centers for Medicare and Medicaid Services, Roseanne Pawelec, said a "common theme" in some of the proposed rules changes was a concern over inappropriate billing by states.

The Baldacci administration said pending rule changes would reduce federal funding for significant programs for the elderly, persons with developmental disabilities, school-aged children and persons with mental illness.

"If these changes are allowed, families and elders will be put at risk, more people will end up in shelters, on the streets, in hospitals or in jail. This is a shortsighted strategy that will increase costs in the long run. These programs are effective and compassionate, and lead to better overall outcomes. Every community in Maine will be hurt by these changes," the governor said in a prepared statement.

According to Baldacci administration officials, one change slated for early March would exclude from funding case management services provided by child welfare/child protective services; probation and parole; public guardianship and special education.

Another upcoming change cited by state officials would disallow federal funding for transportation of school-age students to and from school.

State officials also warned against a proposed narrowing of funding eligibility for rehabilitation services.

The Democratic speaker of the Maine House of Representatives, Glenn Cummings of  Portland, said one proposed change would harm Mainers living in group homes by precluding reimbursement for room and board and require case managers for people with developmental disabilities or brain injuries living in group homes to document that services were producing demonstrable improvements.

"The Bush administration is forcing people who depend on group homes for cost-effective and quality care to turn to hospital emergency rooms and homeless shelters, where it costs government more to provide less help," Cummings said in a statement.

Federal officials trace congressional scrutiny of allowable case management services to the Deficit Reduction Act of 2005.

"Given the uncertainty of the national economy and the $95 million revenue downturn we're already dealing with, it will be difficult for Maine to replace the federal funding," the governor said Wednesday.

"We have been working with the state's congressional delegation, the National Governors Association and Rep. Henry Waxman, (the California congressman) who is planning hearings on the changes, to oppose the proposed new rules," the governor said.