Nursing homes claimed a victory late last week after the Senate approved a war appropriations bill that contains a moratorium on six of seven unpopular Medicaid provisions.

Among those Medicaid rules stopped by the bill are the Cost Limit for Public Providers, which would narrow the definition of a public provider; Allowable Provider Taxes, which would tighten the “hold harmless” test; and Case Management Services, which would limit Medicaid coverage for case management. Taking effect will be the rule excluding certain Medicaid services from coverage as outpatient hospital services. The bill includes more than $21 billion in domestic spending, including funds for hospitals and healthcare programs.

The cost of the legislation, including both war funding and domestic spending, will top $257 billion, a full $154 billion more than the amount the president originally called for. The House has also passed the bill. Despite the exorbitant price tag, President Bush is expected to sign the bill this week.