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Bicameral Democratic Leaders Urge HHS to Protect Equal Access to Medicaid Providers

Jun 22, 2015
Press Release

The letter was sent by House Energy and Commerce Committee Ranking Member Frank Pallone, Jr. (D-NJ), Senate Finance Committee Ranking Member Ron Wyden (D-OR), Senate Finance Health Care Subcommittee Ranking Member Debbie Stabenow (D-MI), House Energy and Commerce Health Subcommittee Ranking Member Gene Green (D-TX), House Ways and Means Committee Ranking Member Sander Levin (D-MI), and House Ways and Means Health Subcommittee Ranking Member Jim McDermott (D-WA).

“With millions of Americans around the nation covered by Medicaid and millions more gaining eligibility for Medicaid benefits, oversight and enforcement of the Medicaid Act’s equal access provision is of critical importance,” the Ranking Members wrote in the letter.

Historically, when states have reduced provider rates to an inadequate level, providers have been able to sue the states in order to ensure that Medicaid was properly enforced.  However, due to a recent Supreme Court ruling in Armstrong v. Exceptional Child, Medicaid providers can no longer sue states for paying illegally low rates and must rely on HHS to take administrative action instead.  In light of the Court’s decision, the lawmakers are urging HHS to take action as soon as possible to ensure that the requirements of Medicaid are enforced and that Medicaid enrollees’ access to care is not impacted.

The lawmakers urged, “CMS must provide firm and immediate oversight to ensure that states are setting and maintaining their Medicaid rate structures as Congress intends in section 1902(a)(30)(A) of the Medicaid Act—consistent with efficiency, economy and quality of care and at levels sufficient to ensure that care and services are available to Medicaid enrollees at least to the extent they are available to the general population in the geographic area.”

The full letter can be found here.