Prosthetic devices and diagnostic screening are "optional services" covered by Medicaid that could be scaled back in the interest of balancing the budget, according to House Energy & Commerce staffers.

Acknowledging that cuts could occur this year, a Democratic staffer warned: "I just hope that if we do look at those things, that we're careful about giving flexibility to states to actually reduce those services."

The statement arose during the Feb. 3 National Health Policy Conference in Washington, D.C. Participants expressed concern that optional add-on items in the Medicaid program might dilute its overall effectiveness and reimbursement rates.

Under the optional service program, CMS has granted states the opportunity to receive federal funds for providing services outside the realm of basic care. Optional services also include: clinic services; nursing facility services for those under 21 years; intermediate care facility/mentally retarded services; prescribed drugs; TB-related services; and dental services.

Medicare and Medicaid cuts could be imminent, given President Bush's desire to balance the budget within five years while maintaining current spending levels on homeland security and defense. So far, Medicaid appears more vulnerable.

Also during the meeting, a staffer for Senate Majority Leader Bill Frist (R-Tenn.) noted that while Social Security got high billing in President Bush's Feb. 2 State of the Union address, Medicare and Medicaid solvency are far more urgent. "If [the President] would have talked about those same numbers and those same years with Medicaid and Medicare, it would have been much worse and much sooner," the staffer said.

In addition, the Senate will introduce "The Healthy America Act of 2005" (S 4) - seeking to reform the medical liability system - within "the next couple of weeks," the staffer added.

At the World Health Care Congress Feb. 1, Rep. Patrick Kennedy (D-R.I.) proposed that "information technology will allow us...to eliminate the errors and the [unnecessary] costs that are endemic in our system."

Prosthetics, Screening, “Optional Services” That Could Face Medicaid Cuts

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