WASHINGTON WIRE

In this issue, you'll find:

• House Budget Bill Faces Uncertainty
• Medicaid Relief Approved for Hurricane Survivors in Louisiana
• Medicare Part D Prescription Drug Benefit News
• Hearings

Top Story

House Budget Bill Faces Uncertainty

On Thursday, November 10, 2005, the House leadership announced they would delay a much anticipated vote on a five-year reconciliation package (H.R. 4241).

Earlier this month, the Senate approved its $34 billion reconciliation bill, finding approximately $10 billion in savings from both Medicare and Medicaid. Overall, the House's reconciliation bill, aims to find more than $50 billion in savings from mandatory programs including $11.8 billion in cuts to Medicaid with no changes to Medicare. The discrepancy in savings outlined in the two bills, and specifically the difference in Medicaid savings between the House and Senate versions, have many observers anticipating a difficult conference.

Although debate over the Arctic National Wildlife Refuge (ANWR) remains a major hurdle for passage of the House legislation, many moderate Republicans such as Congresswoman Heather Wilson (R-NM), continue to oppose the bill's inclusion of Medicaid provisions they state will harm some of the country's poorest individuals. Specifically, members find fault in cost-sharing proposals that aim to require and/or increase co-pays for services such as doctors' visits and prescription drugs under Medicaid. Concern has also been expressed over provisions that would make it more difficult for those in need of long-term care to qualify for Medicaid coverage.

The House is expected to consider the reconciliation bill next week. However, it remains unclear as to whether the leadership will be able to secure the votes needed for passage.

Health Care News

Medicaid Relief Approved for Hurricane Survivors in Louisiana

The Department of Health and Human Services (HHS) approved a Medicaid waiver on Thursday, November 10, 2005, that would ease Medicaid enrollment restrictions for Hurricane Katrina survivors residing in the state of Louisiana.

The 1115 waiver will establish a state fund to cover physicians and hospitals costs, nursing home care, and other health care provider costs required by hurricane victims. The fund will cover costs not normally allowed under Louisiana’s Medicaid benefit package, such as mental health services. The state could also provide prescription drugs and medical devices to those otherwise ineligible for Medicaid including childless adults. Additionally, pregnant women, people with disabilities, evacuees up to age 19 and their families, low-income Medicare beneficiaries, and select persons needing long-term care will receive a five-month enrollment in the Medicaid program.

Upon the enactment of this wavier, Louisiana becomes the thirteenth state currently operating under an emergency Section 1115 demonstration providing relief to storm victims.

Medicare Part D Prescription Drug Benefit News

On Tuesday, November 8, 2005, the Centers for Medicare and Medicaid Services (CMS) announced it is developing a contingency plan to ensure that dual eligibles (individuals eligible for both Medicare and Medicaid) who have not signed up for a new Medicare Part D plan by January, are still able to receive their prescriptions drugs.

The impact of the new Medicare prescription drug plan on dual eligibles has been a concern for many stakeholders as those currently receiving their prescription drugs under Medicaid are required to transfer onto a Medicare Part D plan. Some fear that the transition could create a gap in coverage when those who have not been enrolled by CMS or on their own accord, are unable to receive coverage for their prescriptions.

According to CMS, the backup plan would allow pharmacies to fill prescriptions for dual eligibles that have not been enrolled in a Part D plan. The individual would then be contacted by a CMS contractor who would assist the individual in Part D enrollment.

In a related story, the Kaiser Family Foundation and the Harvard School of Public released a report on Thursday indicating that many seniors remain unclear as to how the new Medicare Part D prescription drug plan will impact them and unsure of whether or not they will enroll.

With the Part D enrollment set to being on November 15, 2005, the report finds that six out of ten seniors surveyed stated they know the prescription drug plan "not too well" or "not at all." Forty-three percent of seniors surveyed stated that they do not know if they will enroll, while thirty-seven percent stated that do not plan to enroll and twenty percent stated that they do plan to participate.

However, the survey also shows that seniors are becoming increasingly educated about the prescription drug plan as seventy-four percent say they have received information about Medicare Part D and of those, sixty percent reported that they have read it closely.

The survey results can be found at www.kff.org/kaiserpolls/med111005pkg.cfm.

Upcoming Events

Hearings

Monday, November 14, 2005

Conference FY2006 Labor HHS Education Appropriations Bill (HR 3010)
6:30PM
HC-5 The Capitol
Mark Up - HR 3010

Wednesday, November 16, 2005

Committee on Agriculture
10:00AM
1300 Longworth House Office Building
Review of the issues related to the prevention, detection, and eradication of avian influenza

Thursday, November 17, 2005

Committee on Energy and Commerce - Subcommittee on Health
9:30AM
2123 Rayburn House Office Building
Medicare Physician Payment: How to Build a More Efficient Payment System

Committee on Agriculture, Nutrition, and Forestry
10:00AM
328-A Russell Senate Office Building
Avian Influenza: Role of U.S. agriculture to control and eradicate

For More Information

For further information on any topics discussed or publications listed, or to get copies of anything mentioned in this alert, please call (202) 466-6550 and ask for the Legislative Practice Group.

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