[Congressional Record Volume 154, Number 161 (Friday, October 3, 2008)]
[Extensions of Remarks]
[Page E2231]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




INTRODUCTION OF THE PROTECTING HOSPITAL OUTPATIENT AND COMMUNITY CLINIC 
                    SERVICES ACT OF 2008 (H.R. 7219)

                                 ______
                                 

                          HON. JOHN M. McHUGH

                              of new york

                    in the house of representatives

                        Friday, October 3, 2008

  Mr. McHUGH. 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.

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