Medicaid Regulations Moratoria/Physician Ownership Restrictions Advance
On May 15, the House of Representatives approved an supplemental spending bill (H.R. 2642) that would extend a current moratorium on implementation of certain Medicaid regulations and block additional rules through April 1, 2009. The rules affected by the legislation involve: payments to public safety net institutions; coverage of rehabilitation services for people with disabilities; outreach and enrollment in schools and specialized medical transportation to school for children covered by Medicaid; graduate medical education payments; coverage of hospital clinic services; case management services; state provider tax laws; and appeals filed through HHS. The bill also would provide $25 million annually to fund Medicaid anti-fraud activities. To finance the legislation, the bill would extend an electronic asset verification demonstration for Medicaid applicants and beneficiaries, and temporarily borrow money from the Physician Assistance and Quality Improvement (PAQI) Fund. The Senate Appropriations Committee also has approved a version of supplemental spending legislation that would likewise block the various Medicaid rules, and in addition would eliminate, for new hospitals with physician ownership, the "whole hospital" exception to the Stark law's referral prohibition, and would add, for existing hospitals with physician ownership, significant additional conditions to that exception. The full Senate is expected to consider a revised version of the legislation this week; the two versions of the bill would need to be reconciled before being sent to the President, who has expressed opposition to the House version of the bill.
