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Outpatient services limited by new Medicaid rule?

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Richard Pollack
outpatient services
Centers for Medicare and Medicaid Services (CMS)
American Hospital Association (AHA)

Intended to curb abuses in billing, the Centers for Medicare & Medicaid Services issued a rule to limit different outpatient services offered by Medicaid. Out of a group of seven rules initially proposed earlier this year, the CMS rule was the only one not overturned by President Bush in June. Both hospitals and patient advocacy groups argued that the seven rules would would eventually cause big cuts in funding.

Richard Pollack, executive vice president of the American Hospital Association, still feels that the lone remaining rule can only be bad news for patients. "This regulation will jeopardize important community-based services, including screening, diagnostic and dental services for children, as well as lab and ambulance services," he said.

In attempting to clarify how the new rule will affect patients, CMS said in a statement that it will "address ambiguity in the definition of outpatient hospital services," to try to make clear the differences between "outpatient hospital facility services" and "other covered Medicaid benefits."

To learn more about this CMS rule:
- read this Modern Healthcare article
- or check out this article

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