States will have a funds set-aside requirement equal to 90 percent of the percentage of total medical assistance funds paid in FY 1995 for persons with disabilities. Medicare cost sharing for Qualified Medicare Beneficiaries. The Secretary should have a time certain to act. Other individuals or families as defined by the state but below 275 percent of poverty. At a minimum, all other benefits defined as optional under the current Medicaid program would remain optional and long term care options significantly broadened.
States have complete flexibility in defining amount, duration and scope of services.
There should be no private right of action for providers or health plans. States must not have federally imposed limits on the number of beneficiaries who may be enrolled in any network. States must have complete authority to set all health plan and provider reimbursement rates without interference from the federal government or threat of legal action of the provider or plan. The Boren amendment and other Boren-like statutory provisions must be repealed. States must be able to set their own health plan and provider qualifications standards and be unburdened from any federal minimum qualification standards such as those currently set for obstetricians and pediatricians.