Executive Summary: On December 4, 2007, CMS released an interim final rule on case management services. This rule will become final on March 3, 2008 without legislative action to impose a moratorium. Yesterday, Senators Barbara Mikulski (D-MD), Norm Coleman (R-MN), and Amy Klobuchar (D-MN) filed an amendment to the Indian Health Care Improvement Act (S 1200) that would place a moratorium on CMS’ rule on case management and targeted case management services until April 1, 2009. This bill is currently pending for consideration on the Senate floor.

Action Needed: The National Council urges all members to contact their Senators today and ask them to support Senators’ Mikulski, Coleman, and Klobuchar’s amendment to the Indian Health Care Improvement Act (S 1200) that would place a moratorium on CMS’ rule on case management and targeted case management services until April 1, 2009.
To find your Senators, go to: www.senate.gov. You can reach all members of Congress by contacting the Capitol Switchboard at 202-224-3121 and asking to be connected to the office you wish to contact.

What should you say?
Once you are connected to your Senator’s office, let them know you are calling to support an amendment to S. 1200 to delay implementation of CMS’ Interim Final Rule on case management.

Talking points:

• The case management rule disproportionately affects kids in foster care,  
  people with developmental disabilities, and individuals with serious 
  mental illnesses.

• The regulation strays far beyond the TCM definition contained in the DRA.

• Finally, the rule is hugely controversial and shifts costs to cash strapped 
  state and county governments.

Please let the National Council know if you contact your Senator on this issue. Contact Allison Fort at AllisonF@thenationalcouncil.org to let us know you participated and share the response you received.

Background Information:
You may remember that the Deficit Reduction Act (DRA) provided legislative changes to case management and targeted case management, and these interim rules reflect, and in some instances go further than, the legislative intent of the DRA. The American Public Human Services Association (APHSA) has created a side by side comparison of areas of the TCM Interim Final Rule that extends beyond the authorization of the DRA Conference Report. Both an overview and a chart are available online.