Medicaid, SCHIP, and Other Health Provisions in H.R. 5661: Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000

Summary

While largely comprised of Medicare provisions, the Medicare, Medicaid, and SCHIP Benefits

Improvement and Protection Act of 2000 ( H.R. 5661 ), a compromise agreement

between House and Senate committees and the leadership, includes a number of important changes

to Medicaid and the State Children's Health Insurance Program (SCHIP). It also includes major

provisions amending other programs. The provisions of H.R. 5661 are incorporated,

by reference into H.R. 4577 , the Consolidated Appropriations Act 2001.

H.R. 4577 was passed by the House and Senate on December 15, 2000 and was signed

into law on December 21 ( P.L. 106-554 ).

Among the major Medicaid modifications are several provisions affecting disproportionate

share hospital (DSH) payments provided to hospitals that treat a disproportionate share of uninsured

and Medicaid enrollees. The agreement increases the disproportionate share hospital allotments for

states. It also extends a special DSH payment rule for public hospitals in California to qualifying

facilities in all states, and provides additional funds to certain public hospitals not receiving DSH

payments. In addition to these DSH provisions, the bill replaces cost-based reimbursement with a

prospective payment system for Federally Qualified Health Centers (FQHCs) and Rural Health

Centers (RHCs). The agreement also modifies proposed rules governing upper payment limits on

inpatient and outpatient services provided by certain types of facilities, and requires that the final

regulations be issued by the end of 2000.

One major SCHIP provision extends the availability of unused funds from FY1998 and FY1999

and redistributes these unused funds among both those states that spend and those that do not spend

their full original allotments for these years. Current law requires that these unused funds be

distributed only to those states that spend their allotments.

Among other major provisions, the agreement requires that outreach efforts be implemented

to identify individuals who may be eligible for Medicaid payment of Medicare cost-sharing and to

notify these persons of the availability of such assistance. It increases the authorization of annual

appropriations for the Maternal and Child Health Services Block Grant under Title V. In addition,

the bill extends for 1 year, to FY2003, the authority for grants to be made for both the Special

Diabetes Program for Type I Diabetes and the Special Diabetes Programs for Indians and increases

total funding for FY2001 through FY2003. Finally, the agreement provides an additional FY2001

direct appropriation for the Ricky Ray Hemophilia Relief Fund.

For information on the Medicare provisions, see CRS Report RL30707(pdf) , Medicare

Provisions

in H.R. 5661: Medicare, Medicaid and SCHIP Benefits Improvement and Protection Act

of 2000.