80R15894 CME-D
 
  By: Delisi H.C.R. No. 206
 
 
 
HOUSE CONCURRENT RESOLUTION
         WHEREAS, In January 2007 the Centers for Medicare and
  Medicaid Services (CMS) proposed a new regulation that would
  radically alter the method by which the federal government
  determines its contribution to state Medicaid providers; if
  implemented, this rule would threaten Texas' health care safety net
  and jeopardize the solvency of facilities that provide crucial but
  unprofitable services, including trauma centers, rural emergency
  departments, university research hospitals, nursing homes, and
  school-based clinics; and
         WHEREAS, The proposed rule, CMS-2258-P, includes a number of
  provisions with potentially devastating consequences to the
  state's health care system; the rule seeks to narrow the definition
  of a "unit of government," thereby prohibiting the care provided by
  certain entities from being used to calculate a state's Medicaid
  contribution, to restrict the way a state is permitted to use
  federal matching funds, and to limit the amount a state can
  attribute to a particular service provided under Medicaid for
  purposes of determining the federal reimbursement; and
         WHEREAS, Texas is particularly vulnerable to the limitations
  of the new definition; many of the state's health care providers
  operate under contractual agreements with the state, county
  governments, or hospital districts, but under the new rule services
  provided by these entities would no longer be permitted to
  contribute to the state's share of the Medicaid program; the
  consequence of this new limitation is most troubling for rural
  Texas, where access to care is already inadequate; and
         WHEREAS, Moreover, the many public hospitals in Texas that
  perform a critical dual purpose by delivering costly, highly
  specialized treatment such as trauma care, neonatal intensive care,
  and burn patient care, while also providing Medicaid services to
  the severely disabled, aged, indigent, and uninsured, depend on the
  federal allocation under Medicaid to remain financially viable; the
  new restriction on the use of federal matching funds proposed under
  CMS-2258-P would jeopardize these hospitals' solvency and further
  strain their capacity to serve as the state's health care safety net
  while also providing essential emergency medical services to the
  community at large; and
         WHEREAS, Unfortunately, the ill effects of the new rule also
  extend to non-hospital providers such as nursing homes,
  intermediate care facilities, community health centers, and
  school-based health clinics for which Medicaid reimbursement and
  supplemental payments are a vital source of funding; these entities
  are essential components of the state's health care delivery
  system, and the loss of federal funds currently used in their
  operation would require the state to find alternative sources,
  shifting money from other state priorities; and
         WHEREAS, The Texas Health and Human Services Commission
  estimates the implementation of CMS-2258-P will cost Texas $788
  million annually in combined state and federal funds, not including
  the considerable administrative costs associated with the rule's
  new documentation and auditing requirements; and
         WHEREAS, The potential impact of CMS-2258-P has raised broad
  bipartisan objection to its implementation; in the 109th United
  States Congress, 300 members of the house of representatives and 55
  members of the senate wrote to the secretary of the United States
  Department of Health and Human Services (HHS) with the request that
  the agency abandon plans to approve a similar rule; and
         WHEREAS, Since CMS-2258-P was proposed in January, a vast
  majority of the United States Congress has once again expressed
  opposition to adoption of the policy; likewise, states across the
  nation have communicated their concerns about the measure, and the
  National Governors Association has requested that the rule be
  withdrawn; and
         WHEREAS, The Texas Health and Human Services Commission has
  also written the secretary of HHS to emphasize the consequences of
  the rule to the state's health care system and to request that the
  rule be withdrawn; given the significance of CMS-2258-P to health
  care providers across the country, concerns of state Medicaid
  administrators relating to the ambiguities of the rule, the
  overwhelming bipartisan congressional opposition to its adoption,
  and the fact that the adoption of the rule would permit CMS to
  overstep its statutory authority as prescribed by congress, it is
  fitting that congress intervene at this time; now, therefore, be it
         RESOLVED, That the 80th Legislature of the State of Texas
  hereby respectfully request the United States Congress to direct
  the secretary of the United States Department of Health and Human
  Services to withdraw proposed rule CMS-2258-P, published on pages
  2236 through 2258, volume 72, number 11, of the Federal Register,
  relating to 42 Code of Federal Regulations Parts 433, 447, and 457;
  and, be it further
         RESOLVED, That the Texas secretary of state forward official
  copies of this resolution to the president of the United States, the
  speaker of the house of representatives and the president of the
  senate of the United States Congress, the secretary of the United
  States Department of Health and Human Services, and all members of
  the Texas delegation to the congress with the request that this
  resolution be officially entered in the Congressional Record as a
  memorial to the Congress of the United States of America.