[Congressional Record Volume 154, Number 67 (Friday, April 25, 2008)]
[Extensions of Remarks]
[Page E744]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




             PROTECTING THE MEDICAID SAFETY NET ACT OF 2008

                                 ______
                                 

                               speech of

                        HON. SHEILA JACKSON-LEE

                                of texas

                    in the house of representatives

                        Tuesday, April 22, 2008

  Ms. JACKSON-LEE of Texas. Mr. Speaker, I rise today in strong support 
of H.R. 5613, the ``Protecting the Medicaid Safety Net Act of 2008.'' I 
would like to thank my colleagues Congressman John D. Dingell and 
Congressman Tim Murphy for introducing this important legislation.
  Mr. Speaker, this legislation will make vital strides toward 
expanding and improving access to healthcare to people in our 
communities who need it most.
  The Protecting the Medicaid Safety Net Act of 2008 is critical to 
keeping the doors open for the patients who use the public hospital 
systems throughout the country. In my home State of Texas, there was 
statewide and national support from various stakeholders, the 
Physicians, Governors, County Judges, Mayors, and many others all 
encouraging passage of H.R. 5613.
  Section 2 of H.R. 5613 amends the U.S. Troop Readiness, Veterans' 
Care, Katrina Recovery, and Iraq Accountability Appropriations Act, 
2007 to extend until April 1, 2009, the moratorium on implementation of 
a proposed rule, ``Medicaid Program; Cost Limit for Providers Operated 
by Units of Government and Provisions to ensure the integrity of the 
Federal-State financial partnerships under Medicaid and State 
Children's Health Insurance Program, SCHIP, of the Social Security Act, 
SSA.
  This Act will extend the moratorium until April 1, 2009, on any 
action by the Secretary of Health and Human Services, to restrict 
Medicaid payments for graduate medical education. It also, amends the 
Medicare, Medicaid, and SCHIP Extension Act of 2007 to extend until 
April 1, 2009, the moratorium on certain restrictions relating to 
Medicaid coverage or payment for rehabilitation services or school-
based administration and school-based transportation,
  This moratorium establishes additional moratoria until April 1, 2009, 
on specified regulatory actions concerning Medicaid: (1) treatment of 
optional case management services; (2) outpatient hospital services; 
and (3) allowable provider taxes.
  Section 3 allows appropriated funds to go to the Secretary for the 
purpose of reducing fraud and abuse in the Medicaid program. It 
requires annual reports to specified congressional committees on 
activities funded by such appropriations, allowing for greater 
accountability to the people.
  More importantly, this Act will direct the Secretary to contract with 
an independent organization to produce a comprehensive report for 
Congress on the prevalence of such problems: (1) identifying which 
claims for items and services under Medicaid are not processed through 
automated data systems; (2) examining the reasons why they are not so 
processed; and (3) recommending Federal and State actions that can make 
claims for such items and services more accurate and completely 
consistent with Medicaid requirements.
  The administration has propagated Medicaid rules which would limit 
children's access to health care.
  According to the Congressional Budget Office, CBO, President Bush and 
the Centers for Medicare and Medicaid Services, CMS, intend to 
implement seven separate Medicaid rules which would reduce Federal 
Medicaid spending by $20 billion over the next 5 years.
  Specifically, the regulations would be:
  1. Narrowing the range of rehabilitation services covered.
  2. Narrowing the range of targeted case management services covered.
  3. Limiting the outreach services provided by schools and ending 
reimbursement for transportation to and from school for children with 
disabilities.
  4. Narrowing the range of allowable provider taxes.
  5. Limiting the definition of outpatient hospital services provided.
  6. Eliminating Federal Medicaid graduate medical education support
  7. Limiting State funding mechanisms, including intergovernmental 
transfers, and capping public provider reimbursement.
  The combined effect of these actions would be disastrous to the 
health of all children and children's hospitals.
  1. Many of these regulations threaten the most vulnerable children--
children who require the specialty services that Medicaid provides.
  2. Children's hospitals care for the sickest and neediest children in 
our Nation. On average, half of the care children's hospitals provide 
is to children covered by Medicaid.
  3. Because children's hospitals are so dependent on Medicaid funding, 
any decrease in Medicaid reimbursement would have a profound impact on 
children's hospitals' abilities to fulfill their core missions of 
clinical care, training, and research. By undermining the Medicaid 
safety net, these rules could threaten the ability of all children to 
access needed health care services.
  H.R. 5613, the Protecting the Medicaid Safety Net Act of 2008, would 
place a moratorium until April 1, 2009 on all of these Medicaid 
regulations. I am proud to cosponsor legislation that will add service 
before self to our leaders of tomorrow. I urge my colleagues to join me 
in supporting this legislation.




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