ACTION ALERT: Protect Medicaid Reimbursement for Case Management

Protect Medicaid Reimbursement for Case Management

Ask your Senators and Representative to Cosponsor Legislation Delaying Medicaid Regulations


Background

Last month, the Centers for Medicare and Medicaid Services (CMS) issued an interim final rule (CMS-2237-IFC). This regulation will drastically cut Medicaid funding for case management services that currently assist Medicaid-eligible children and adults with disabilities to access essential long term supports, social, medical, educational and other services.

We are opposed to a number of the provisions of this rule, particularly the following new restrictions:

Transition case management services, which are critical to assisting individuals in moving from institutions to the community, are limited to a maximum of 60 days. Current CMS policy allows for up to180 days, which is often necessary to find housing and necessary supports for an individual to live in the community.

Providers can only be paid for transitional case management services once an individual has successfully transitioned into the community. Unfortunately, due to circumstances well beyond the control of service providers (e.g., the availability of appropriate support services), transition can occur long after the necessary case management services have been provided. Many service providers do not have the financial capacity to wait for reimbursement or to sustain the financial losses if an individual’s transition is not successful.

Status

February, 2005 - The Deficit Reduction Act (DRA) was signed into law. The DRA provided new definitions of case management under the Medicaid program.

December, 2008 – CMS published its interim final rule in response to the DRA which restricts Medicaid reimbursement for case management services. Medicaid experts believe that the interim final rule goes well beyond Congress’ intent in passing the DRA.

January, 2008 – Representative Keith Ellison (D-MN) introduced H.R. 5173, a bill to temporarily delay application of proposed changes to Medicaid payment rules for case management services until April of 2009. Senator Norm Coleman (R-MN) introduced S. 2578, the Senate version of the bill.

March 3, 2008- The Medicaid Case Management Regulation will go into effect unless legislation is passed.



Take Action


I. Call Your Representative

1) If your Representative is not one of the cosponsors of H.R. 5173 listed below, please call your Representative (contact information is available at http://www.house.gov/house/MemberWWW.shtml).
Cooper, Jim (D-TN)
Cummings, Elijah E. (D-MD)
Duncan, John J., Jr. (R-TN)
McCollum, Betty (D-MN)
Oberstar, James L. (D-MN)
Peterson, Collin C. (D-MN)
Ramstad, Jim (R-MN)
Walz, Timothy J. (D-MN)

2) Ask to speak to the Medicaid staff person and say:

The Medicaid case management regulation:
*greatly exceeds Congress’ intent when it passed the Deficit Reduction Act.
*will put service providers at great financial risk by severely restricting Medicaid
reimbursement for critical services.
*ultimately harms our most vulnerable citizens – children and adults with disabilities.

I am asking for Representative __________ to cosponsor H.R. 5173, the bill to delay implementation of the Medicaid case management regulation.



II. Call Your Senators

1) If your Senators are not among the list of cosponsors of S. 2578 listed below, call your Senators’ offices (contact information is available at http://www.senate.gov/general/contact_information/senators_cfm.cfm.)
Alexander, Lamar (R-TN)
Bingaman, Jeff (D-NM.)
Cardin, Ben (D-MD)
Casey, Bob (D-PA)
Clinton, Hillary (D-NY)
Corker, Bob (R-TN)
Domenici, Pete (R-NM)
Klobuchar, Amy (D-MN)
Leahy, Patrick (D-VT)
Mikulski, Barbara (D-MD)
Salazar, Ken (D-CO)

2) Ask to speak to the Medicaid staff person and say:
The Medicaid case management regulation:
*greatly exceeds Congress’ intent when it passed the Deficit Reduction Act.
*will put service providers at great financial risk by severely restricting
Medicaid reimbursement for critical services.
*ultimately harms our most vulnerable citizens – children and adults with
disabilities.

I am asking for Senator __________ to cosponsor S. 2578, the bill to delay implementation of the Medicaid case management regulation.