Important CMS Rules Update: The Clock Is Ticking

As we have reported before on this blog, the proposed CMS Rule Changes that affect reimbursement on case management services. Here is a brief recap of the proposed changes.

Background:
The proposed rules will drastically cut Medicaid funding for case management services that provide adults and children with long term supports, social, medical, educational and other services. The rules would change current CMS policy in the following ways:
*Transition case management services would be limited to 60 days. Current policy allows for up to 180 days. It often takes up to 180 days to secure housing and necessary support services for a person to transfer into a community independent living environment.
*Providers will only be paid for transitional case management services when the person successfully transitions into the community. This rule can be a financial hardship on service providers who do not have a financial capacity to wait for a reimbursement. Sometimes a transition is not successful for various reasons such as the availability of appropriate support services. In this case if the persons transition is not successful the provider will not receive reimbursement, again creating a financial hardship for the provider.

On February 14th Senator Norm Coleman (R-MN), Barbara Mikulski (D-MD), and Amy Kobuchar (D-MN) introduced an amendment to the Indian Health Services Act reauthorization bill. This amendment will impose a moratorium on the targeted case management interim final rule until April 1, 2009. The Senate approved the amendment to this reauthorization bill. The Senate will be back in session on February 24th.

UPDATE:
Today the Senate will vote on final passage of the Indian Health Services reauthorization legislation (S. 1200) today. The bill includes a one year moratorium on the Medicaid case management interim final rule.

On Wednesday, Steve Larson, Director of Public Policy for The Arc of Minnesota, will speak at House and Senate staff briefings on the impact of the Centers for Medicare and Medicaid Services case management interim final rule on persons with intellectual and developmental disabilities.

The clock is ticking on the new CMS rules which are set to go into effect on March 3, 2008.

We will keep you up to date on the vote and the progress of this important one year moratorium.