I 

110TH CONGRESS 

2D SESSION H. R. 5613 

To extend certain moratoria and impose additional moratoria on certain 

Medicaid regulations through April 1, 2009. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 13, 2008 

Mr. DINGELL (for himself and Mr. TIM MURPHY of Pennsylvania) introduced 

the following bill; which was referred to the Committee on Energy and 

Commerce 

A BILL 

To extend certain moratoria and impose additional moratoria 

on certain Medicaid regulations through April 1, 2009. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Protecting the Med5 icaid Safety Net Act of 2008’’. 

6 SEC. 2. MORATORIA ON CERTAIN MEDICAID REGULATIONS. 

7 (a) EXTENSION OF CERTAIN MORATORIA IN PUBLIC

8 LAW 110–28.—Section 7002(a)(1) of the U.S. Troop 

9 Readiness, Veterans’ Care, Katrina Recovery, and Iraq 


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1 Accountability Appropriations Act, 2007 (Public Law 

2 110–28) is amended— 

3 (1) by striking ‘‘prior to the date that is 1 year 

4 after the date of enactment of this Act’’ and insert5 ing ‘‘prior to April 1, 2009’’; 

6 (2) in subparagraph (A), by inserting after 

7 ‘‘Federal Regulations)’’ the following: ‘‘or in the 

8 final regulation, relating to such parts, published on 

9 May 29, 2007 (72 Federal Register 29748)’’; and 

10 (3) in subparagraph (C), by adding at the end 

11 the following: ‘‘, including the proposed regulation 

12 published on May 23, 2007 (72 Federal Register 

13 28930)’’. 

14 (b) EXTENSION OF CERTAIN MORATORIA IN PUBLIC

15 LAW 110–173.—Section 206 of the Medicare, Medicaid, 

16 and SCHIP Extension Act of 2007 (Public Law 110–173) 

17 is amended— 

18 (1) by striking ‘‘June 30, 2008’’ and inserting 

19 ‘‘April 1, 2009’’; 

20 (2) by inserting ‘‘, including the proposed regu21 lation published on August 13, 2007 (72 Federal 

22 Register 45201),’’ after ‘‘rehabilitation services’’; 

23 and 


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1 (3) by inserting ‘‘, including the final regulation 

2 published on December 28, 2007 (72 Federal Reg3 ister 73635),’’ after ‘‘school-based transportation’’. 

4 (c) ADDITIONAL MORATORIA.— 

5 (1) IN GENERAL.—The Secretary of Health and 

6 Human Services may not, prior to April 1, 2009, im7 pose (or continue in effect) any requirement, prevent 

8 the implementation of any provision, or condition the 

9 approval of any provision under any State plan 

10 under title XIX or XXI of the Social Security Act, 

11 any amendment of such a plan, or demonstration 

12 project request relating to such plan or title, on the 

13 basis of any policy or interpretation relating to a 

14 provision described in paragraph (2) or to any rule, 

15 provision, policy, or interpretation similar to such a 

16 provision. 

17 (2) PROVISIONS DESCRIBED.—The provisions 

18 described in this paragraph are the following: 

19 (A) PORTION OF INTERIM FINAL REGULA20 TION RELATING TO MEDICAID TREATMENT OF

21 OPTIONAL CASE MANAGEMENT SERVICES.— 

22 (i) The interim final regulation relat23 ing to optional State plan case manage24 ment services under the Medicaid program 

25 published on December 4, 2007 (72 FedVerDate Aug 31 2005 03:43 Mar 18, 2008 Jkt 069200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H5613.IH H5613

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1 eral Register 68007) in its entirety, except 

2 as provided in clause (ii). 

3 (ii) Clause (i) shall not apply to the 

4 portion of such regulation as relates di5 rectly to implementing section 

6 1915(g)(2)(A)(ii) of the Social Security 

7 Act, as amended by section 6052 of the 

8 Deficit Reduction Act of 2005 (Public Law 

9 109–171), through the definition of case 

10 management services and targeted case 

11 management services contained in pro12 posed section 440.169 of title 42, Code of 

13 Federal Regulations, but only to the extent 

14 that such portion is not more restrictive 

15 than the policies set forth in the Dear 

16 State Medicaid Director letter on case 

17 management issued on January 19, 2001 

18 (SMDL #01–013), and with respect to 

19 community transition case management, 

20 the Dear State Medicaid Director letter 

21 issued on July 25, 2000 (Olmstead Update 

22 3). 

23 (B) PROPOSED REGULATION RELATING TO

24 REDEFINITION OF MEDICAID OUTPATIENT HOS25 PITAL SERVICES.—The proposed regulation reVerDate Aug 31 2005 03:43 Mar 18, 2008 Jkt 069200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H5613.IH H5613

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1 lating to clarification of outpatient clinic and 

2 hospital facility services definition and upper 

3 payment limit under the Medicaid program 

4 published on September 28, 2007 (72 Federal 

5 Register 55158) in its entirety. 

6 (C) PORTION OF PROPOSED REGULATION

7 RELATING TO MEDICAID ALLOWABLE PROVIDER

8 TAXES.—The final regulation relating to health9 care-related taxes under the Medicaid program 

10 published on February 22, 2008 (73 Federal 

11 Register 9685) in its entirety, other than the 

12 portion of such regulation as relates to the fol13 lowing: 

14 (i) REDUCTION IN THRESHOLD.—The 

15 reduction from 6 percent to 5.5 percent in 

16 the threshold applied under section 

17 433.68(f)(3)(i) of title 42, Code of Federal 

18 Regulations, for determining whether or 

19 not there is an indirect guarantee to hold 

20 a taxpayer harmless, as required to carry 

21 out section 1903(w)(4)(C)(ii) of the Social 

22 Security Act, as added by section 403 of 

23 the Medicare Improvement and Extension 

24 Act of 2006 (division B of Public Law 

25 109–432). 


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1 (ii) CHANGE IN DEFINITION OF MAN2 AGED CARE.—The change in the definition 

3 of managed care as proposed in the revi4 sion of section 433.56(a)(8) of title 42, 

5 Code of Federal Regulations, as required 

6 to carry out section 1903(w)(7)(A)(viii) of 

7 the Social Security Act, as amended by 

8 section 6051 of the Deficit Reduction Act 

9 of 2005 (Public Law 109–171). 

Æ 


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