House members and senators have sent letters to HHS Secretary Mike Leavitt in opposition to a proposed rule announced in January by CMS that would limit state Medicaid reimbursements to health care providers, CongressDaily reports (Johnson, CongressDaily, 3/21). Under the rule, state Medicaid reimbursements to health care providers operated by local governments could not exceed actual costs, and providers, rather than state and local governments, would have to receive all reimbursements to which they are entitled. CMS said that the rule would help eliminate financing agreements under which health care providers receive state Medicaid reimbursements that exceed the actual cost of services and states receive extra matching funds from the federal government as a result. The rule would save the federal government an estimated $3.9 billion over five years, CMS said. According to CMS, local governments or hospital districts nationwide operate 1,153 hospitals, 822 nursing homes and 113 intermediate care centers for the mentally retarded (Kaiser Daily Health Policy Report, 1/16). In separate letters to Leavitt, 100 House members and 60 senators asked for a withdrawal of the rule, which they maintain would disproportionately affect more expensive, critical health care providers, such as trauma centers and emergency hospitals in low-income areas. The letters also maintain that the rule exceeds the statutory authority of CMS. The public comment period on the rule ended last week (CongressDaily, 3/21).