Protecting Hospital Outpatient and Community Clinic Services Act of 2008

Madam Speaker, on September 29, 2008, I introduced legislation, the Protecting Hospital Outpatient and Community Clinic Services Act of 2008 (H.R. 7219), which would prohibit the U.S. Secretary for Health and Human Services (HHS) from taking any action before April 1, 2009, to implement a proposed regulation related to the redefinition of Medicaid outpatient hospital services. This initiative was developed by HHS' Centers for Medicare and Medicaid Services (CMS) and was published on September 28, 2007 (72 Federal Register 55158).

The proposal is designed to limit the definition and scope of Federally reimbursable Medicaid outpatient services provided in a hospital clinic or facility as well as those offered in a rural health clinic. CMS has stated that it is unable to determine the fiscal impact of the rule and that they believe this measure would not significantly alter current practices in most states. However, the National Association of State Medicaid Directors (NASMD) reports that the proposed regulation ``would significantly affect the Medicaid program in every state.'' According to one source, in New York State alone, health care providers would lose over $452 million. It is important to note that this estimate, large as it is, excludes the costs encountered by hospital settings. By way of example, New York's 23rd Congressional District, which I have the privilege of representing, would lose over $2.6 million in Federal funding. Moreover, even after attempting to fully analyze this complex regulation, New York State is still unable to fully assess the total magnitude of its impact.

Needless to say, such a loss of funding would have a devastating impact upon the health care infrastructure, and thus the residents, of Northern and Central New York. Specifically, several constituent providers have estimated the proposed rule would not only reduce their ability to provide critical services to some of our nation's most vulnerable individuals but also literally force these providers out of business.

As stated above, CMS readily admits, it does not fully understand the impact of its actions. The State of New York has documented that the proposal would result in significant negative consequences. In the face of such circumstances, prudence demands that the rule's actual consequences be thoroughly examined, and well understood, before its implementation. H.R. 7219 would provide CMS, and Congress, until April 1, 2009, to closely examine the proposed rule and act accordingly. Thus, I urge my colleagues to join with me to enact this legislation before the conclusion of the 110th Congress.