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Capitol Correspondence - 09.15.20

White House Sends Congress Memo on Including Certain Medicaid Programs in Potential Short-term Budget Extension

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ANCOR has been a leading advocate for the Money Follows the Person program, which is currently on a temporary extension through the month of November and which the White House’s Office of Management and Budget (OMB) included in a memo to Congress. The memo focused on programs the White House wishes to see included in potential short-term legislation that would avoid a federal government shutdown when the fiscal year concludes at the end of September. The short-term extension will likely be necessary because Congress has not yet passed the Fiscal Year 2021 budget.

As reported by Inside Health Policy:

“The White House is asking Congress to fund certain so-called Medicare and Medicaid extenders — most of which are set to run through Nov. 30 — as part of an expected continuing resolution to keep the government open in fiscal 2021, and an Office of Management and Budget document obtained by sister news service Inside Defense also says the White House would consider other policies that often ride along with the extenders, like a delay in cuts to Medicaid Disproportionate Share Hospital payments.

As part of the CARES Act, lawmakers funded a number of extenders through Nov. 30, including the Special Diabetes Programs, teaching health center graduate medical education program, community mental health services demonstration, Money Follows the Person demonstration, State Health Insurance Programs, Area Agencies on Aging, and Aging Disability and Resource Centers.

The OMB memo says the White House wants these programs further extended in an anticipated continuing resolution (CR) to keep the government open past Sept. 30, even though the programs’ funding will not have run out quite yet.

While the House has passed several spending bills for fiscal 2021, the Senate has not, and lobbyists anticipate a CR will be needed by the end of the month. House Speaker Nancy Pelosi (D-CA) and Treasury Secretary Steve Mnuchin reportedly have reached a tentative agreement to continue funding the government past the end of the fiscal year, which would avert a government shutdown.

The OMB memo says that, along with the programs the White House considers necessary for inclusion in the CR — if they aren’t passed as part of something else first — there are a number of items that the executive branch would consider acceptable additions.

Those include: a floor on the work geographic adjustments under the Medicare Physician Fee Schedule, funding for CMS’ quality measure work, spousal impoverishment protection for beneficiaries of home- and community-based services, a further extension of the DSH cut delay and an extension of the Medicare Rural Community Hospital Demonstration.

Many of these policies were also handled through Nov. 30 as part of the CARES Act, including the DSH cut delay, but the Rural Community Hospital demo had been extended for five years under the 21st Century Cures Act in 2016 and is set to expire at the end of 2021. That demo has been running since 2004 and has been extended multiple times.

The memo does not say for how long the White House would like to see its priorities funded or extended.”