HHS urged to finalize Medicaid equal access rule

Ranking members of House and Senate committees with jurisdiction over federal health care programs yesterday urged Health and Human Services Secretary Sylvia Burwell to finalize a 2011 rule proposing a process to ensure that states reimburse Medicaid providers sufficiently under the Medicaid Act’s equal access provision. “Historically, lawsuits by Medicaid providers have helped keep pressure on states to prevent them from arbitrarily reducing provider rates to meet certain budgetary objectives without considering the impact on enrollee’s access to care,” the committee leaders wrote. “…With the [Supreme] Court’s ruling in Armstrong, however, the enforcement burden has immediately shifted onto [the Centers for Medicare & Medicaid Services].” In a 5-4 ruling in March, the Supreme Court held that parties cannot challenge directly in federal court a state’s compliance with Section 30(a) of the Medicaid Act, which requires states to reimburse providers at rates sufficient to ensure beneficiaries enjoy the same access to health care as the general population. The AHA and Federation of American Hospitals had urged the court to uphold the right of health care providers to take states to court when they fail to live up to their payment obligations under the Medicaid Act.