Sens. Schumer, Clinton Criticize Proposed Medicaid Rule On Outpatient Services

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Women's Health / Gynecology;  Public Health;  Mental Health
Article Date: 12 Sep 2008 - 6:00 PDT

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Sen. Charles Schumer (D-N.Y.) on Tuesday called Center for Medicare and Medicaid Services Acting Administrator Kerry Weems to urge Weems to drop a proposed rule that would narrow the scope of hospital outpatient services covered by Medicaid, CongressDaily reports. Schumer and Sen. Hillary Rodham Clinton (D-N.Y.) also recently wrote to President Bush about the issue.

The proposed rule would reduce Medicaid payments to 120 upstate New York health clinics by $65 million, Schumer said, adding that family planning clinics, school-based health care clinics, mental health clinics, dialysis centers and hospital outpatient clinics would be affected by the rule (CongressDaily, 9/11).

Schumer said that final action on the proposal could be taken by CMS within one month, adding that many clinics have told him they will have to cut back services or close, the Syracuse Post-Standard reports. He added, "Most people regard these services as sacrosanct. They are the first line of defense for people who don't have health insurance or adequate insurance." The state Department of Health estimated that New York state would lose $450 million if the proposal is enacted (Mulder, Syracuse Post-Standard, 9/11).

Schumer and Clinton's letter, dated Sept. 3, says that the effects of the proposed rule would have a "devastating impact" on many health clinics by lowering the reimbursement rate. Many of the services offered by the clinics that would be impacted by the rule are not covered by Medicare and "are meant to address the needs of populations that are different from those served by Medicare," the letter says. Schumer and Clinton added that the rule would have an "unacceptable impact on care and treatment for the low-income families that are in greatest need of specialized health care services" (Clinton release, 9/3).

According to CongressDaily, Weems was "not deterred" by his conversation with Schumer. CMS spokesperson Jeff Nelligan said the proposed rule "enhances the integrity of the Medicaid program, ensuring that the services provided [to] our Medicaid recipients are effective and that taxpayers are receiving the full value of the funds spent on Medicaid" (CongressDaily, 9/11).

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