The CMS has issued a final rule that would limit the types of outpatient hospital services covered by Medicaid.
The rule was originally proposed along with six others as a means to help tighten areas of the Medicaid program that are ripe for abusive billing practices, but instead drew immediate fire from hospital and patient advocacy groups that said the actions would only lead to steep cuts in important funding.
In June, six of those seven rules were overturned as part of a broader spending bill passed by Congress and signed by President Bush. The outpatient rulethen just a proposalstayed in play.
This regulation will jeopardize important community-based services, including screening, diagnostic and dental services for children, as well as lab and ambulance services, Richard Pollack, executive vice president of the American Hospital Association, said in the associations trade publication, AHA News.
Pollack said that the association would lobby federal lawmakers to impose a moratorium on the rule during the lame-duck session of Congress this year.
The rule does not include certain payment limits that were part of CMS earlier proposal, though those issues could come up again.
The proposed changes would address ambiguity in the definition of outpatient hospital services which allowed for a high possibility of overlap between outpatient hospital facility services and other covered Medicaid benefits, the CMS wrote in its final rule. -- by Matthew DoBias
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