|
Volume 13 Number 42 News: Medicaid BOSTON--Four state Medicaid agencies filed suit against the federal Department of Health and Human Services Feb. 29, asking the U.S. District Court for the District of Columbia to strike down a new rule restricting reimbursement for case management services (Maine Department of Health and Human Services v. U.S. Department of Health and Human Services, D. D.C., case number unavailable, 2/29/08). The interim final rule, which went into effect on March 3, will "jeopardize the health and safety of Medicaid beneficiaries, limit state flexibility to provide case management in the most effective and efficient manner, and result in a substantial reduction in federal funds" for case management services, the four state agencies told the court. The lawsuit was filed by Maine, Maryland, New Jersey, and Oklahoma. David Loughran, a spokesman for Maine Attorney General G. Steven Rowe (D), said other states are affected by the rule and are considering joining the litigation. The agency rule will cost Maine $16 million over the next two fiscal years, Loughran said. Figures were not available for the other three states. A spokeswoman for HHS was not available for comment. Alleged Violation of Deficit Reduction Act According to the complaint, the challenged provisions of the rule violate the Deficit Reduction Act of 2005. The HHS secretary did not provide notice or seek comment before publishing the rule in the Federal Register on Dec. 4, 2007, and the rule goes beyond the secretary's authority and is arbitrary and capricious, the state Medicaid agencies said. Since 1986, the plaintiff agencies said, "case management" and "targeted case management" have been services that a state may elect to provide as a Medicaid benefit to Medicaid-eligible beneficiaries. These services assist beneficiaries in gaining access to medical, social, educational, and other services. Congress clarified the scope of the services under the Deficit Reduction Act and stated that costs were reimbursable, according to the complaint. The interim rule is not in accordance with that law because it excludes the delivery of foster care services, restricts the states' right to direct the delivery of underlying services, limits the scope of underlying administrative activities, and removes the ability of the state to require assessments for affected populations, the states alleged. "This federal rule will abruptly cut off funding that helps protect the health and safety of our state's most vulnerable citizens," Rowe said in a statement. By eliminating fundamental services, the rule will lead to "a lower quality of life and an increase in the cost of care the state will have to provide," he said.
|
