New Fed regulations to shift billions in Medicaid costs to states

Upcoming Medicaid regulations from the Bush administration will "shift billions of dollars in costs to states after studies from the Government Accountability Office supported its assertion that states have used questionable practices to generate more federal payments than they deserve."(Source: "MEDICAID: Administration To Issue New Rules That Shift Costs to States," American Health Line, Feb. 12, 2008.) The first regulation will be issued March 3 and "ends payments for ancillary services provided under case-management plans. The administration considers these services, which can include assistance finding housing or paying utility bills, outside the scope of Medicaid. The second regulation, to be issued May 25, would limit how much states could pay health care providers; end Medicaid reimbursements for medical intern and resident salaries; end reimbursements to schools for busing Medicaid-eligible students; and limit the range of services that could be considered rehabilitation for Medicaid patients." According to Barbara Edwards, interim director of the National Association of State Medicaid Directors, "There is a concern that there is a reshaping to some extent of the Medicaid program--in particular the benefits Medicaid will cover--in ways that states are concerned will result in cost-shifting to the states from the federal government or will result in a loss of services."