September 2001

Bush Revises Medicaid Rules

Washington, D.C. - The Bush administration has proposed a new set of protections for patients on Medicaid, giving states more power over the details, while shelving stricter rules developed under former President Bill Clinton.

The move means patient rights promised by Congress in 1997 will not be in place until early next year at the earliest. Some Democrats described the move as a delaying tactic and accused the Bush administration of weakening patient rights for poor Americans in favor of insurance companies. States welcomed the changes, saying the new version is more workable.

As a result of the changes, health plans will have more time to consider patient complaints, and states will have more control over what quality improvement programs they establish.

Democrats complained about the substance of the new regulation as well as the delay. A letter from 12 New York House Democrats complained the move effectively denies patient rights for “the most vulnerable citizens.”

“The Bush administration has taken every opportunity to side with the HMO industry and against Medicaid patients,” Rep. Henry Waxman (D-Calif.), said.

Waxman cited other changes, most notably the time frames health plans have to deal with patient complaints: In the Clinton version, plans had 72 hours to resolve emergency appeals; under the Bush version, they have three working days. In the Clinton version, plans had 30 days to resolve non-emergency appeals; under the Bush version, they have 45 days.

In 1997, Congress gave states the right to move Medicaid participants into cost-cutting health maintenance organizations and other managed care plans without first getting permission from the U.S. Department of Health and Human Services. In return, HHS was to write regulations assuring patients certain rights, much like the rights Congress has debated for patients in the private sector.

Source: Associated Press

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