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April 3, 2008 By Fawn Johnson Members of the House Energy and Commerce Committee today skewered a series of Medicaid regulations that states claim would cost them at least $50 billion over five years. Energy and Commerce Chairman John Dingell and Rep. Tim Murphy, R-Pa., have introduced legislation to place a one-year moratorium on seven regulations. The bill faces hurdles, including a $1.6 billion cost that must be offset and possible Senate opposition. Four of the regulations addressed in the Dingell/Murphy bill are under a moratorium that expires in the summer. The Senate budget resolution includes language to maintain that moratorium for another year, but it is not clear if it will act on the other three. During a break in the hearing, Energy and Commerce Health Subcommittee Chairman Frank Pallone, D-N.J., said one option for moving the legislation would be to attach it to another must-pass bill. "But we haven't made any decisions," he said. At the hearing, Dingell said, "When one reviews how [Centers for Medicare and Medicaid Services] dealt with comments submitted on the regulations, it appears that there was no intention of working with the states or other beneficiary groups to find common ground." Dingell cited thousands of comments CMS has received protesting the rule. Only a handful of communiques to CMS "contained a positive comment," Dingell noted, quoting the agency directly. Murphy agreed with many committee Republicans who do not support his bill that CMS should put a stop to Medicaid waste, fraud, and abuse. But the "disabled and infirm" served by Medicaid "should not be bearing the burden" as policymakers seek solutions, he said. As a psychologist, Murphy said he has personal experience with the program. "I'm not sure any of us understand the system, even in the administration," he said. CMS Medicaid and State Operations Director Dennis Smith told the subcommittee the Dingell/Murphy bill would thwart the administration's efforts to "apply fiscal accountability in Medicaid. ... As currently written, [the bill] would not simply delay implementation of these regulations, but it could jeopardize policies and interpretations that predate these regulations," he said. Galen Institute President Grace-Marie Turner said lawmakers should "work with administration" on amending the rules "rather than block them completely." GAO Acting Director on Health Issues James Cosgrove said his investigators found that in the past several years, some states had overpaid providers to draw more federal matching funds, and then secured rebates from the same providers. But under questioning, from Dingell, Cosgrove said GAO had issued no recommendations regarding the specific topics addressed in the seven Medicaid regulations.
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