March 3, 2008
John C. Porter
As you know, Nevada faces a state budget shortfall of roughly $540 million. Nevada Medicaid is being reduced roughly $80 million (Fed/State) as its share of the budget cuts. On top of that cut, the federal share (known as FMAP) of Medicaid is being reduced from roughly 52.5% to 50% which will cost an additional $19.7 million in SFY 09. Moreover, increased caseloads caused by our economic turndown, are likely to lead to additional cuts.
Over the past year the Administration has proposed or issued regulations which will force states to make significant changes to Medicaid. If implemented, it is estimated that Nevada will lose $262 million in Medicaid funded services over the next five years unless we replace federal dollars with state General Fund. At a time of such a budget crisis, shifting costs to our state and local governments forces Nevada to make difficult choices between vital services and an additional burden on our tax payers. The below signed cross section of advocates and providers strongly urge you to protect Nevada from these harmful changes by passing legislation to extend existing moratoria on harmful regulations and to delay additional regulations which will go into effect if Congress fails to act. A number of programs/services are impacted. Here are a few examples:
Last year Congress
acted on a bipartisan basis to pass legislation to temporarily delay implementation
of regulations which would have significantly restricted federal support
for services provided to children in schools, for rehabilitation services
provided to children and people with disabilities, and for our health
care safety net. These moratoria are scheduled to expire this spring
will be particularly damaging to Nevada if the regulations go into effect.
Support Legislation to Delay Harmful Medicaid Regulations
To date, the following
bills have been introduced to extend or enact moratoria to delay various
Medicaid regulations. In upcoming weeks, it is likely that a bill will
be introduced to delay all of the regulations.
H.R. 5173 / S. 2578 Temporarily delays application of proposed changes to Medicaid payment rules for case management and targeted case management services. Targeted Case Management: The regulation significantly limits federal Medicaid matching funds for case management services. The Deficit Reduction Act (DRA) made some changes to Medicaids case management benefit, but the regulation the Centers for Medicare and Medicaid Services issued to implement these changes goes far beyond what Congress intended and will have a detrimental impact on beneficiaries, especially children in foster care and people with physical or mental disabilities or other chronic health conditions. Status: Interim Final Rule goes into effect March 3rd.
Imposes a one-year moratorium on the regulations or other administrative
actions to restrict Medicaid coverage or payment for rehabilitation services,
or school-based administration, transportation, or medical services.
Claiming and Transportation Costs for School-based Services
The regulation eliminates federal funds for outreach, enrollment assistance,
coordination of health care services, and related activities by school
personnel to enroll more eligible poor children in Medicaid. The rule
also would reverse current policy that allows federal funds to be used
to transport children to school if the children have special health needs
and receive health care services at school. Status: Final rule issued;
implementation delayed by Congressional action until 6/30/08.
Extends by one year the moratorium on implementation of the hospital
cost-limit rule and on finalization of the graduate medical education
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