Medicaid "needs fundamental structural reforms that will return the program to a federal and state partnership," Center's for Medicare & Medicaid Services (CMS) Administrator Tom Scully told the House Energy and Commerce Committee during a hearing on the program. Scully used the hearing to push a Bush administration proposal to reform Medicaid with what amounts to a block-grant approach. The proposal has met stiff opposition and carries no momentum in Congress. States have taken advantage of loopholes in the Medicaid program to get higher federal reimbursements than they deserve, Scully said. Although the CMS has worked to close those loopholes, the program still needs restructuring, he said.