CMS Moratorium Political Strategies (2/8/2008)

The countdown to June 30th continues. That is the day when the moratorium on the rules issued by the Centers for Medicare and Medicaid Services (CMS) expires. Congress passed the moratorium last December as a part of the S. 2499 (now Public Law No: 110-173), the Medicare, Medicaid, and SCHIP Extension Act of 2007, and it prevents CMS from implementing regulations that would restrict payment under title XIX of the Social Security Act for rehabilitation services or school-based administration and school-based transportation. It reads:

SEC. 206. MORATORIUM ON CERTAIN PAYMENT RESTRICTIONS.
Notwithstanding any other provision of law, the Secretary of Health and Human Services shall not, prior to June 30, 2008, take any action (through promulgation of regulation, issuance of regulatory guidance, use of Federal payment audit procedures, or other administrative action, policy, or practice, including a Medical Assistance Manual transmittal or letter to State Medicaid directors) to impose any restrictions relating to coverage or payment under title XIX of the Social Security Act for rehabilitation services or school-based administration and school-based transportation if such restrictions are more restrictive in any aspect than those applied to such areas as of July 1, 2007.

Many in Washington are now racing against the clock. Led by a the American Association of School Administrators and the National Education Association, a broad coalition is working with members of Congress to draft legislation that will, at least, extend the moratorium until 2009 when the administration turns over and Michael O. Leavitt is no longer the Secretary of Health and Human Services. The coalition is working with the members of the House Committee on Energy and Commerce and the Senate Finance Committee, the committees with jurisdiction over the matter, to first draft legislation and then to find a bill sponsor and co-sponsors.

Yet, the problem is not with support for the action, but with finding sufficient budget offsets for the legislation. The Democratic leadership in the House is still operating under Pay Go rules, which require that any new funding must be offset either through program cuts or raising taxes. Whether such legislation would require an offset, and the cost of that offset, is now under discussion. Once that is resolved, any newly drafted CMS moratorium bill would not move on its own but be attached to another piece of legislation that will be signed by the President, although the question of who the President will be at that time is also part of the strategy debate. We are actively taking part in this process and will report on any progress as it occurs.

Resources:
Medicare, Medicaid, and SCHIP Extension Act of 2007, S.2499, http://thomas.loc.gov/cgi-bin/query/z?c110:S.2499:, (chose option 1).
Elicia J. Herz, CRS Report for Congress: Medicaid and Schools (Congressional Research Service, updated December 20, 2007), http://opencrs.com/document/RS22397/.
Author: DAD