RS22852
Medicaid and Outpatient Hospital Services
May 28, 2008
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Summary
On September 28, 2007, a proposed Medicaid rule was published that would (1) change the definition of outpatient hospital and rural health clinic services and (2) change the methods states must use to demonstrate compliance with the federal upper payment limit on outpatient hospital services provided in private outpatient facilities. A number of groups have expressed concern that this rule will have a significant negative impact on coverage of certain services, which may harm Medicaid beneficiaries. This report summarizes the details of this rule, CMS's justifications for the proposed changes, and arguments against the rule.
