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November 4, 2009

Nixon Announces Additional Expenditure Restrictions
Gov. Jay Nixon predicts state revenue will decline 5 or 6 percent this year rather than the year-to-date revenue shortfall of 10 percent. Nixon announced $203.7 million in additional expenditure restrictions as a result of the budget shortfall. The new restrictions list $32 million in Medicaid cost containment, including provider rate reductions. Nixon and his staff did not provide details as to how the Medicaid spending reductions will be distributed between providers.

HHS To Waive Regulatory Requirements For H1N1 Treatment
U.S. Department of Health and Human Services Secretary Kathleen Sebelius notified Congress of the intent to waive several regulatory requirements under Section 1135 of the Social Security Act when treating individuals for H1N1. These waivers may affect the following.

  • Medicare Conditions of Participation, certification and program participation requirements
  • physician state licensure requirements that relate to Medicare and Medicaid reimbursement
  • actions under EMTALA
  • sanctions under the Stark self-referral regulations
  • payment limitations for out-of-network services under Medicare+Choice
  • HIPAA privacy sanctions and penalties
  • deadlines and timetables for the performance of required activities

State Releases MO HealthNet Employer Report
The Missouri Department of Social Services released the numbers of Missouri Medicaid participants by employer. The report identifies 2,300 Missouri employers of more than 150 employees. Out of these, 172 employers had 50 or more employees who either received MO HealthNet benefits or were responsible for a family member who was a MO HealthNet participant. A review of the workforce data pertaining to hospitals indicates several significant errors.

David Lieb, a reporter for the Associated Press, wrote a story on the history of this report.

President Signs Emergency Declaration For H1N1
President Obama signed a declaration pursuant to the National Emergencies Act on H1N1 and consistent with section 1135 of the Social Security Act as amended. The most immediate effect of this declaration allows the president to authorize the U.S. Department of Health and Human Services to temporarily waive certain standard federal requirements to enable health care facilities to implement emergency operations. These waivers , as well as other H1N1 guidance documents , are available on MHAnet.

Democrats Continue Their Talks On Health Care Reform
The focus on health care overhaul legislation shifts to the House this week as Democrats will likely introduce the chamber’s new adjustments to its principal measure . House Speaker Nancy Pelosi, D-Calif., is crafting a measure that she hopes will include a public insurance option. However, she has been unable to gather the necessary support. Controlling health care costs and tax provisions are two contentious topics in the House bill. Meanwhile, Senate Democrats have delayed debate on their own health care reform measure
(S. 1679 /S. 1796) until early November. Both a variation of a state opt-out for a public option and a “trigger” to implement a public option are stirring discussions among lawmakers.

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