U.S. Rep Urges Scully’s Ouster over Medicare Reimbursement Controversy in Iowa
In a letter to President Bush, Rep. Leonard Boswell (D-Iowa) said CMS Administrator Tom Scully should be fired for his criticism of Iowa officials' plan to legally challenge federal Medicare reimbursement formulas, the AP/Omaha World-Herald reports (AP/Omaha World-Herald, 8/23). The rates under dispute stem from the Balanced Budget Act of 1997, which set payments to states based in part on data such as local wages and costs. The Medicare per-beneficiary reimbursement rate in Iowa is $3,053 per year -- the lowest of any state -- compared to the national average of $5,490 per year. On Monday, Gov. Tom Vilsack (D) and Attorney General Tom Miller (D) said that they would first send a letter to HHS Secretary Tommy Thompson and then file a lawsuit to try to force the government to calculate states' Medicare payments "equivalently." The lawsuit would focus on language in federal laws regulating how HMOs contract with Medicare to provide coverage for beneficiaries in different states. The guidelines require Medicare to reimburse HMOs with "actuarial equivalence" among all states. On Tuesday, Scully said that although he and Thompson are sympathetic to smaller states' reimbursement concerns and have taken steps to address them, Vilsack and Miller are "kidding themselves" in proposing the lawsuit (California Healthline, 8/21).
The AP/World-Herald reports that Scully "angered many" by describing the proposed lawsuit as "ridiculous" and "absurdly irresponsible." In response, Boswell wrote to Bush, saying, "Scully has made his view of the Bush administration's position on Medicare reimbursements very clear. Medicare equity is not currently a priority for his agency." During a press conference in Des Moines, Boswell said, "To allow Scully to remain as head of Medicare would be absurdly irresponsible to the 15 million seniors in the 35 states who are currently being discriminated against." Boswell added the reimbursement rate issue is a "real test" for the Bush administration. "The only question left for the administration is: Where do they stand on this critical issue?" he said. The AP/World-Herald reports that Stan Thompson (R), who is running against Boswell, "agreed with the criticism" against Scully. "I would hope Scully will do everything possible to persuade his colleagues and members of Congress from other states that this is an issue that needs to be addressed immediately," Thompson said (AP/Omaha World-Herald, 8/23).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.