Taking CMS Issues to Congress

A consortium of opponents to the proposed rule changes related to Medicaid reimbursements for school-related administrative and transportation costs are taking the issue to members of Congress. The Center for Medicare & Medicaid Services (CMS) has attempted to pass this rule for almost 20 years, but has taken its efforts further this year by announcing a proposed rule in the Federal Register earlier this month. Meeting with no success in appealing to CMS and the current Administration, advocates for the program are taking their issues to Congress, hoping to spur legislation that will keep CMS from instituting and enforcing the proposed rule.

School districts all over the country receive federal reimbursement for an estimated $3.6 billion over five years in Medicaid services provided to children with disabilities. Schools rely on these reimbursements for a variety of purposes, such as outfitting buses with specialized equipment, transporting children to school for their medical appointments, identifying students who need screenings and evaluations, and connecting children and their families with other needed services in their community. CMS, which is under the jurisdiction of the Department of Health and Human Services, argues that it should not have to reimburse school-related costs. Advocates for the program have been successful in stopping CMS before it can move on this rule every year until now.

Some lawmakers have taken mild steps towards legislation that would prohibit CMS from going through with its proposed rule, but efforts have been ineffective so far. Presently, advocates are sending individual and dear colleague letters to members of Congress, asking for their support of any legislative efforts towards that end. The most likely vehicle for this legislation is currently the State Children’s Health Insurance Program (SCHIP), which is in conference at the time of this Update’s publication. The House version of the bill included a provision that would prevent CMS from moving forward on the rule, but it is not clear if that provision will make it into the conference report. Another likely vehicle would be an omnibus appropriations bill. The 60-day comment period on the proposed rule ends in November, leaving just over a month for advocates to lobby Congress for assistance in keeping the program running.

Author: SAS