The National Governors Association on Tuesday detailed its recommendations for changes to Medicaid, proposals which were initially presented in June during congressional testimony, CQ HealthBeat reports. The governors' recommendations for Medicaid include:

• Strengthening asset transfer rules, including increasing the "look-back" period for beneficiaries' asset transfers from three years to five years;
  
  
• Permitting the use of "reverse mortgages" to offset long-term Medicaid costs;
  
  
• Increasing cost-sharing for beneficiaries with annual incomes above the federal poverty level;
  
  
• Streamlining the waiver application process for states;
  
  
• Allowing states to offer different benefits packages depending upon the beneficiaries' health;
  
  
• Clarifying the process by which Medicaid pays for prescription drugs;
  
  
• Adopting closed prescription drug formularies; and
  
  
• Increasing the minimum rebates that states collect on brand-name drugs from 15.1% to 20%, in order "to ensure lower total costs that would not solely impact pharmacists" (CQ HealthBeat, 8/30).
  

Reaction
The proposals come as the Senate Finance Committee is working to provide by Sept. 16 a list of areas -- including Medicaid -- in which spending could be reduced by $10 billion over five years. NGA said the proposals reflect "common-sense, enforceable cost-sharing," which the governors said would "increase responsibility" of Medicaid beneficiaries and "encourage cost-effective care" (Bleed, Arkansas Democrat-Gazette, 8/31). Arkansas Gov. Mike Huckabee (R), chair of NGA, said, "These latest recommendations are part of our ongoing process to find ways to reform Medicaid." Huckabee added, "They are driven by good public policy and are designed to make Medicaid more efficient and effective, not to generate any particular budget saving number." House Energy and Commerce Committee Chair Joe Barton (R-Texas) said the NGA recommendations will receive "serious consideration," adding that the latest proposals were the "most specific advice to date" (CQ HealthBeat, 8/30).

The recommendations are available online. Note: You will need Adobe Acrobat Reader to view the proposals.