Fwd: FCC: Proposed Medicaid Rule Changes

[Guest guest]

Looking for simple solutions to your real-life financial challenges? Check out WalletPop for the latest news and information, tips and calculators.

Family Care Council Communication:

For your information and sharing.

The following information was received from National APSE.

Bob Wessels

Employment Coordinator, Community Outreach, FCC Liaison

Agency for Persons with Disabilities

201 West Broward Blvd., Suite 305

Fort Lauderdale, FL 33301

Tel: - Fax:

Email: _Wessels@...

www.apdcares.org

You have received this message because at one time you requested

information from the Family Care Council, Area 10. If you received this

message in error or wish to be removed from our distribution list simply

list click here or reply to this email with the word “REMOVE†in the

subject line

The Agency supports Persons with Developmental Disabilities in Living,

Learning and Working in their Community.

----- Forwarded by Wessels/APD/DCF on 09/26/2008 09:00 AM -----

Background:

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 (Disability Policy Collaboration):

|----------------+-----------------------+-------------------------------|

| Service | Medicare Coverage | Impact of Outpatient Rule on |

| | | Medicaid |

|----------------+-----------------------+-------------------------------|

Day Treatment | · * Medicare | No funding for day treatment

| does not pay for day | programs for persons with

| programs for | psychiatric or developmental

| individuals with | disabilities.

| developmental |

| disabilities. |

| · * Medicare |

| does not pay for day |

| treatment such as |

| intensive psychiatric |

| rehabilitation. |

----------------+-----------------------+-------------------------------

Comprehensive | · * Medicare | No funding for some clinic

primary care and| does not recognize | services, such as lab and

ancillary | clinics that provide | radiology services.

services. | comprehensive primary |

| care and ancillary |

|services. Therefore it|

| reimburses them as if |

| they were visits to |

| private physicians. |

----------------+-----------------------+-------------------------------

Select Services | · * Medicare | No funding for clinics that

|does not pay at all for| specialize in mental health

| certain services such | services or services for

|as vision, psychiatric |individuals with developmental

| and dental services | disabilities.

| (but only dental care |

| received as an |

| exception under the |

| proposed rule.) |

In New York State alone, one of the few states that have completed an

analysis of this rule, the proposed changes could result in the loss of

over $450 million per year in federal Medicaid dollars for New York State’s

clinic providers and public hospitals. The proposed Outpatient Rule would

result in potentially devastating changes to Medicaid that would cut funds

to many clinics providing outpatient services that are critical for

individuals with disabilities.

NOTICE: Florida has a broad public records law. Most written

communications to or from state officials are public records that will be

disclosed to the public and the media upon request. E-mail communications

may be subject to public disclosure.