CMS Administrator Nomination Stalls - April 2021
The confirmation of President Joe Biden’s nomination to lead the Centers for Medicare & Medicaid Services (CMS) was delayed by top Senate Republican, Sen. John Cornyn (R-TX), over the recent Texas Medicaid waiver decision.
Sen. Cornyn is blocking Chiquita Brooks-LaSure’s nomination provisionally after the Biden administration rescinded Texas’ 1115 Medicaid Waiver Extension in the Senate Finance Committee. The waiver, which was approved by the Trump administration back in January, proposed to extend the state’s Medicaid plan for another 10 years.
But current CMS officials said they rescinded the waiver because Texas didn’t follow-through with the full rule-making process. The current waiver will remain in place through September 2022, but the main division was concern centered on the state’s Delivery System Reform Incentive Payment (DSRIP) program, set to sunset in September. It was the Trump administration required the “sunset” provision of the DSRIP funds.
In short, DSRIP funds support hospital reimbursement rates and community services that support hospital ER diversion efforts (to reduce ER recidivism rates among high-risk, often uninsured communities). DSRIP funds are also used for uncompensated care.
How long Cornyn’s hold ultimately lasts will be determined by Senate Majority Leader Chuck Schumer (D-NY). Schumer is unlikely to allow Cornyn’s move to disrupt Brooks-LaSure’s final confirmation for too long. CMS said it would work with Texas on its waiver resubmission.