RCPA - Rehabilitation and Community Providers Association


CMS Rescinds Medicaid School-Based, Outpatient Services Definitions, and Case Management Rules
May 5, 2009

The Centers for Medicare and Medicaid Services (CMS) rescinded the November and December 2007 final rules, Elimination of Reimbursement Under Medicaid for School Administration Expenditures and Costs Related to Transportation of School-Age Children Between Home and School and Clarification of Outpatient Hospital Facility (Including Outpatient Hospital Clinic) Services Definition. It rescinded parts of the December 4, 2007 interim final rule, Optional State Plan Case Management Services. The sections of the case management rule that are rescinded include the restrictive definition of individuals transitioning to a community setting, the prohibition against bundling rates, and the intrinsic element test that denies payment for case management services that are part of another program.

The provider tax regulation is delayed for another year to permit more data collection and analysis. The rehabilitative services rule that was also of great concern to providers and advocates was issued as proposed, therefore it is not rescinded. However, information from National Council for Community Behavioral Healthcare indicates that the Obama administration has signaled that the rehabilitative services rule will not be implemented.

The complete announcement will be published in the May 6 Federal Register (www.gpoaccess.gov/fr/browse.html).

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