Tuesday, March 28, 2023

Resident Commissioner Presents Amendment to extend Puerto Rico’s access to Medicaid funding

By on September 22, 2020

Resident Commissioner Jenniffer González (Screen capture of www.gonzalez-colon.house.gov)

Fiscal board has yet to approve several Medicaid-funded programs

SAN JUAN – With less than 10 days until the end of the federal fiscal year, Resident Commissioner Jenniffer González Colón presented an amendment to H.R. 8319, which is the latest continuing resolution to fund the federal government for the next few months.

The amendment seeks to allow the Puerto Rico government to use in the next fiscal year the Medicaid funds authorized by Congress for this fiscal year ending on Sept. 30.

“Given the denial of the Fiscal Control Board with the $1.1 billion for use in the Medicaid program, today I filed an amendment in Congress that allows the government of Puerto Rico to use those monies in the next fiscal year,” the congresswoman said, stressing that its approval would “be able to correct the denial of the Fiscal Control Board with these funds”

González said she had already obtained the funds for the health card for the next fiscal year, so at no time were those funds at risk, she assured. The other programs that will be proposed to the fiscal board to use the additional funds obtained by the lawmaker are for adult vaccines, expanding coverage of diabetes and non-emergency transportation to take patients who do not have the means to their medical appointments.

When negotiations with Congress began in the spring of 2019, the Government of Puerto Rico made the request based on projections for the entire year. However, the funds were authorized within three months of the fiscal year and Puerto Rico used other federal funds to pay for Medicaid during that period and through February 2020.

When Congress authorized Medicaid funding for Puerto Rico late in December, the amounts for fiscal year 2020 included in the bill were not adjusted to the actual time period during which the funds would be spent; therefore, they included projected spending for several months that Puerto Rico could not afford.

CMS took some time to authorize them, one of which is still pending; therefore, the money budgeted for those programs could not begin to be used until late summer, the resident commissioner argued.

Under the Puerto Rico Oversight, Management and Economic Stability Act (Promesa), these programs also require the approval of the Puerto Rico Financial Oversight and Management Board. The fiscal panel has not authorized these programs, so Puerto Rico has not yet disbursed the funds. Some of these programs will be retroactive, but those payments await board approval. Once authorized, a large amount of unused money will be paid.

The largest of the new programs was a plan to increase Puerto Rico’s poverty level for Medicaid eligibility from 40% to 85% of the federal poverty level. The board recently informed ASES that the program would not be approved.

There is not enough time left this fiscal year to request CMS authorization to spend these funds on other new programs, and the money allocated to this program will not be able to be spent this fiscal year.

ASES has identified a list of programs that could be implemented prospectively with the funds, rather than increasing the poverty level, but, due to the time it takes CMS to approve them, they will not be ready before the end of this fiscal year.

González asked the House committee to adopt her amendment, “which would allow Puerto Rico to use the unspent federal funds of the current fiscal year in the next fiscal year and the investment for the purposes that Congress designated them: to provide a better system of health for the country’s residents of Puerto Rico.”

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