Moratorium on CMS Regulations

The moratorium bill (H.R. 2642) was signed into law on June 30 after winning bipartisan approval in the House (416-12) and Senate (92-6). It prohibits CMS from imposing restrictions under 2007-2008 Medicaid regulations on public provider reimbursement, graduate medical education, rehabilitative services, school-based administrative and transportation claiming, case management, and provider-related taxes until at least April 2009. The new law requires USDHHS to submit a report to Congress by January 1, 2009 about the problems that the 2007-2008 regulations were intended to address and to enter into a $5 million contract with an independent organization to study these problems so as to produce another report to Congress by September 2009. It appropriates an additional $25 million annually for OIG activities to reduce Medicaid fraud and abuse. It also requires States and the District of Columbia to phase in asset verification programs under which aged, blind, and disabled recipients must authorize the State to request any financial record from any financial institution that the State determines is needed to verify financial eligibility. California, New York, and New Jersey are already participating in an asset verification demonstration to be fully implemented by September 2009. The new law requires all other States to fully implement asset verification programs no later than September 2013 so as to stay within Congressional budget guidelines.    
 
Asset verification programs will operate in a manner similar to third party liability identification. The programs will utilize asset verification methods that PCG has already successfully implemented under state pharmacy assistance programs. Thomas Aldridge is leading PCG's effort to apply that experience to potential new asset verification projects under the new law.    

Tom Entrikin

Tom Entrikin is a PCG manager and former Medicaid policy specialist with the U.S. Health Care Financing Administration (HCFA), now the Centers for Medicare & Medicaid Services (CMS).