URGE YOUR SENATORS TO ACT ON BILL TO DELAY MEDICAID OUTPATIENT RULE
Help us Block Cuts in Services for People with Developmental Disabilities
The Arc is asking for your help in making one last legislative push to address one of our most important unresolved issues before Congress adjourns for the election.
Yesterday, September 30, Senators Charles Schumer (D-NY) and five other senators introduced the Preserving Access to Healthcare (PATH) Act of 2008 (S. 3656). This bill would delay for six months cuts to Medicaid outpatient payments.
The Centers for Medicare and Medicaid Services (CMS) issued the Proposed Outpatient Rule in September of 2007. This regulation would narrow the definition of outpatient hospital and clinic services and limit Medicaid reimbursement under the hospital outpatient benefit to only those services covered by Medicare.
Importing Medicare concepts into the Medicaid program does not recognize the inherent differences between programs, which serve very different populations. Some of these key differences and their resulting impact under the proposed regulation are summarized in the table below.
Impact of Outpatient Rule on Medicaid
Medicare does not pay for day programs for individuals with developmental disabilities.
Medicare does not pay for day treatment such as intensive psychiatric rehabilitation.
No funding for day treatment programs for persons with psychiatric or developmental disabilities.
Comprehensive primary care and ancillary services.
Medicare does not recognize clinics that provide comprehensive primary care and ancillary services. Therefore it reimburses them as if they were visits to private physicians.
No funding for some clinic services, such as lab and radiology services.
Medicare does not pay at all for certain services such as vision, psychiatric and dental services
No funding for clinics that specialize in mental health services or services for individuals with developmental disabilities.
Call your Senators TODAY. While time for legislative action is running short, there is still an opportunity to build support before Congress leaves for the election!
(Do not call the Capitol Switchboard - all circuits continue to be busy. Use your Senators' office numbers provided when you enter your zip code in the "Call Now" window).