On Feb. 8, 2006, President Bush signed into law the Deficit Reduction Act (DRA) of 2005. The DRA represented the most significant set of changes to Medicaid since its 1965 enactment.
The NACHC reports and fact sheets below provide information on how the DRA affects health centers.
Citizenship Documentation
An Initial Assessment of the Effects of Medicaid Documentation Requirements on Health Centers– A 2007 policy brief based on research conducted at the George Washington University School of Public Health and Health Services. The report reviews the impact of the citizenship documentation requirements in the Deficit Reduction Act (DRA) of 2005 on health centers and their patients.
Fact Sheet on Final Regulations of Citizenship Documentation – A Centers for Medicare and Medicaid Services Fact Sheet issuing clarifying the instructions for their July 12, 2006 Final Rule regarding how states should implement the citizenship documentation requirements in the 2005 DRA.
Interim Final Rule on Citizenship Documentation– A Centers for Medicare and Medicaid Services Final Rule published July 12, 2006 in the Federal Register. The rule amends Medicaid regulations to implement the citizenship documentation provisions of the 2005 DRA.
NACHC Letter to CMS re: Implementation of Documentation of Citizenship– A request that CMS move quickly to send out guidance to the states regarding implementation of the Medicaid citizen documentation provision of the DRA. The letter offers recommendations as to how CMS might allow states the necessary flexibility to minimize the likelihood of Medicaid-eligible persons being denied coverage at the time of application.
The Impact of the DRA Citizenship Documentation Requirement on Special Populations, Issue Brief #93 - A NACHC issue brief concerning the 2005 DRA citizenship documentation requirement; the impact of the requirement on health centers and their patients; and the challenges faced by special populations in establishing U.S. citizenship.
Analysis-A brief legal analysis of the impact on FQHCs of recently enacted state laws requiring verification of legal status of persons seeking or receiving certain benefits, and "model" state legislative language.
Model Legislation-Appropriations Riders re: Medicaid Changes
Model Legislation-Requiring legislative approval of state medicaid changes
Role of State Law in Limiting Medicaid Changes– A National Health Law Program and NACHC 50 state review of state legislation that might restrict the ability of State Medicaid agencies to implement the service and cost-sharing options in the DRA.
Additional Provisions of the Deficit Reduction Act of 2005 Identified for Potential Impact– This two-part report includes an overview of key Medicaid provisions in the DRA by researchers at the George Washington University school of Public Health, as well as a NACHC analysis of provisions, other than those involving citizenship documentation, that might impact community health centers.
Health Center-Hospital Affiliation Opportunities Under the Deficit Reduction Act– A NACHC issue brief focusing on sections of the DRA that offer new opportunities for health centers to collaborate with local hospitals to provide alternatives to furnishing non-emergent, non-urgent outpatient care in the hospital emergency department.
Urgent Alert re: DRA Implementation– A letter from NACHC to PCA directors and staff highlighting several time-sensitive components of CMS’s instructions for implementing the DRA (March 2006).
CMS Directions to States on DRA Implementation – a set of documents issued by CMS directing states on how to implement the provisions of the 2005 DRA.
