The Medicaid Commission: Report to the Honorable Secretary Michael O. Leavitt, Department of Health and Human Service and The United States Congress, September 1, 2005

The following is an excerpt from the September 1, 2005 Medicaid Commission report, which was presented to Secretary Michael O. Leavitt. The Medicaid Commission proposed several cost-saving recommendations, which are listed below.

Recommendations for Savings
The Medicaid Commission received over 100 submissions for consideration for the September 1, 2005 report. The Medicaid Commission charter directs the Commission to report to the Secretary, for his consideration and submission to Congress, by September 1, 2005, their recommendations on options to achieve $10 billion in scoreable Medicaid savings over 5 years while at the same time make progress toward meaningful longer-term program changes to better serve beneficiaries. Based on this requirement for scoreable savings, only options that have been previously scored by either the Congressional Budget Office (CBO) or OACT, or that contained sufficient detail upon submission to allow OACT to provide a score prior to the subsequent Commission meeting, and that demonstrate savings in the 5-year period could be included as options to be presented to the Commission for consideration.

At a public meeting convened August 17-18, 2005, the Commission deliberated and voted on proposed options for savings that were submitted according to the guidelines established by the Commission at its July 27, 2005 meeting. Following presentations of all scored options, Chairman Governor Sundquist and Vice-chair Governor King prepared a Chairman's Mark. This Mark was their suggestion of a package of options which would achieve $11 billion in Medicaid savings over 5 years, and served as a starting point for the Committee deliberations. The Mark consisted of six of the options presented during the first day of the meeting, and reflected the Chairs' recommendations to the Commission.

All Commission members were provided an opportunity to discuss the individual options on the Mark, ask clarifying questions of the subject matter experts present, and move to amend the recommended package by suggesting omissions and substitutions of other options. Three motions were made for amendments. None of the amendments had a sufficient number of votes to pass, and the Chairman's Mark was not modified. The Commission then voted unanimously to adopt the Chairman's Mark without amendment. The Commission recommends the following reforms:

• PRESCRIPTION DRUG REIMBURSEMENT FORMULA REFORM 
  
  
• EXTENSION OF THE MEDICAID DRUG REBATE PROGRAM TO MEDICAID MANAGED CARE 
  
  
• CHANGE THE START DATE OF PENALTY PERIOD FOR PERSONS TRANSFERRING ASSETS FOR MEDICAID ELIGIBILITY
  
  
• INCREASE THE "LOOK-BACK" PERIOD FROM THREE TO FIVE YEARS TIERED CO-PAYMENTS FOR PRESCRIPTION DRUGS FORM OF THE MEDICAID MANAGED CARE ORGANIZATION (MCO) PROVIDER TAX REQUIREMENT