Medicaid bill may run afoul of pay-as-you-go rules

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A bill that would postpone seven onerous Medicaid regulations could collapse as a result of recently enacted legislative rules.

Rep. John Dingell (D-MI) introduced a bill last month that would place a moratorium on these regulations by one year. But the bill could cost $1.65 billion in fiscal years 2008 and 2009, according to the Congressional Budget Office. Pay-as-you-go rules, which went into effect last year, require that lawmakers couple proposals that cost money with legislation that would reduce spending or raise funds of an equal amount.

The Medicaid regulations, several of which are scheduled to take effect in coming weeks and months, would restrict Medicaid payments to publicly-owned nursing homes and hospitals and limit coverage of rehabilitation services for people with disabilities. They could reduce federal payments to states by $50 billion over the next five years, according to a U.S. House committee's report.

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