FMAP Extension Efforts Fail Again

VHCA (6/25/2010)

Last night, the Senate failed to secure the 60 votes needed to overcome a Republican filibuster of the extenders bill that contains the additional Federal Medical Assistance Percentage (FMAP) support and the RUG IV fix.  This is the third time the Senate has voted on a version of the legislation, and Senate Majority Leader Harry Reid (D-NV) said that he was pulling the bill from floor and moving on to a small business jobs bill instead.  For Virginia nursing facilities, the action in the Senate to vote down the measure brings us closer to a scheduled three percent reduction in Medicaid payment rates effective July 1st.

The procedural motion necessary to complete consideration of the bill failed by a vote of 57 to 41.  No Republicans voted for the motion; Sen. Ben Nelson (D-NE) was the sole Democrat to vote against the motion. 

It appears that the effort to pass the bill – which in addition to FMAP and the RUG IV fix contains extensions of unemployment insurance, extended health coverage for the unemployed, and a series of business tax breaks – will be put on hold at least until Congress returns from the July 4th recess, and very possibly indefinitely. 

AHCA/NCAL has already contacted Capitol Hill to express its dismay at the failure to proceed with this legislation and will continue its full court press on the issue.  Efforts include an aggressive lobbying campaign, a massive grassroots effort, and a significant public relations program. 

The time frame for action is very tight.  Congress is scheduled to take its 4th of July recess starting the weekend of the holiday and will not be back until July 12th at the earliest.  It is unclear what day will be the last day before they leave, but Congress could theoretically be in session through the weekend, though that is unlikely.  Then they will be in session through the end of July, but the House intends to start the August recess a week earlier than usual and adjourn at the end of July rather than at the end of the first week in August as is traditional. 

In Virginia, the Department of Medical Assistance Services (DMAS) appears to be following the same wait and see strategy that many providers are pursuing.  Although DMAS has not formally indicated a specific timetable for implementing the three percent reduction, letters to providers have been sent as a reminder that the Department will have no option but to reduce interim payment rates on or after July 1st if the enhanced FMAP initiative is not approved.

Also last night, the House passed H.R. 3962, a bill to reverse the steep cuts in the Medicare Physician Fee Schedule.  The vote was 417 to 1.  The Senate had previously passed the bill by voice vote on June 18, so the bill will go to the White House where President Obama is expected to sign it quickly. 

H.R. 3962 reverses the cuts to the fee schedule, which averaged 21 percent, and replaces them with a 2.2 percent increase through November 30 of this year.  Congress will have to take further actions to prevent the cuts from coming back into place after then. 

VHCA will continue to monitor developments and keep members apprised of the status of efforts to pass the FMAP extension.