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Volume 13 Number 32 News: Medicaid The Senate Feb. 14 approved by a voice vote an amendment to temporarily delay the Centers for Medicare & Medicaid Services from implementing the targeted case management rule the agency has said would take effect March 3. A moratorium until April 1, 2009, was included in an amendment that Sens. Barbara A. Mikulski (D-Md.), Norm Coleman (R-Minn.), and Amy Klobuchar (D-Minn.) introduced for inclusion in the proposed Indian Health Care Improvement Act (S. 1200). A motion to end debate on S. 1200 also was introduced Feb. 14. CMS issued the so-called TCM rule (72 Fed. Reg. 68077) as an interim final rule to clarify situations in which Medicaid would pay for referral services for specific, or targeted groups of Medicaid beneficiaries (No. 231 HCDR, 12/3/07 a0b5m3u8b1). It specifies that the TCM definition does not cover direct medical services and other services that are integral components of another Medicaid program. CMS has said it was concerned about "inappropriate" state billing of Medicaid that had been discovered by the Government Accountability Office. The rule also specified that Medicaid payment would not be available for activities that constitute the administration of foster care programs or other nonmedical programs, CMS said in a Nov. 30, 2007, press release. Examples include guardianship, legal services, and special education services not included in individualized education plans or family services plans. "The rules that CMS has proposed would keep many Medicaid beneficiaries, including members of our tribal communities, from getting the kind of specialized care they need," Senate Finance Committee Chairman Max Baucus (D-Mont.) said in a statement. Further, the rule goes beyond provisions that Congress authorized in the Deficit Reduction Act of 2005, Baucus and Senate Majority Leader Harry Reid (D-Nev.) said Feb. 4 in a letter to the Department of Health and Human Services Secretary Michael O. Leavitt (No. 26 HCDR, 2/8/08 a0b5x7m3q7).
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