CMS Implements $1 Billion Program To Help Hospitals,
Others Recoup Unpaid Emergency Room Costs
CAL/AAEM News Service
calaaem_news at yahoo.com
Mon Aug 9 20:38:24 PDT 2004
CMS Implements $1 Billion Program To Help Hospitals, Others Recoup Unpaid Emergency Room
July 22, 2004
The Centers for Medicare & Medicaid Services (CMS) today announced a
new program to provide $1 billion over four years to help hospitals and
other providers recoup the costs of providing needed medical care to
uninsured patients who cannot pay their hospital bills regardless of
their citizenship status.
"Emergency services are a critical part of public health for everyone
in our communities, including undocumented immigrants," said Mark B.
McClellan, M.D., Ph.D., administrator of CMS. "Hospitals and health
professionals on the front lines of providing emergency care for
everyone need our support. With $250 million a year in new funding, the
new Medicare law gives us a greater ability than ever to provide that
The MMA set aside $250 million a year for the next four years (FY 2005
through 2008) to help hospitals and certain other emergency care
providers recoup a portion of their costs associated with providing
emergency services to qualified individuals who are uninsured or cannot
afford emergency care. Each state will receive funding based on the
formula established in the law. Payments will be made directly to
hospitals, physicians, and ambulance providers, including Indian Health
Service facilities and Indian tribes and tribal organizations, as long
as they did not receive payment from any other source such as the person
treated or an insurance company.
"We intend to use this new program to support all aspects of emergency
treatment - including hospital, physician, and ambulance services - that
have been strained by providing uncompensated care for undocumented
immigrants," said Dr. McClellan. "This funding will strengthen all of
the components of emergency health care to help make sure that everyone
in the community gets emergency help when they need it."
In implementing the new assistance, Medicare proposes to allocate
payments based on the costs incurred for the initial emergency services
and associated services, including physician and ambulance services.
According to the new law, two-thirds of the funds will be distributed to
all states with the remaining third going to those states with the
largest number of apprehensions of undocumented aliens.
Under the Emergency Medical Treatment and Labor Act (EMTALA) hospitals
with emergency rooms are required to treat and stabilize patients who
present with emergency medical needs regardless of their ability to pay
or citizenship status. The cost of this care often strains hospital
budgets and can threaten a hospital's ability to keep its emergency room
"We encourage everyone involved in providing emergency care to review
our proposal and help us craft the best plan to help hospitals and other
providers remain vital providers of health care to their communities,"
Dr. McClellan said.
CMS posted on its Web site a policy paper that outlines the proposed
implementation approach. The agency is seeking public comment through
August 16 and anticipates having an implementation plan in place by the
September 1 deadline set in the Medicare Modernization Act (MMA). The
proposed policy paper can be viewed at
Source: CMS Public Affairs Office
Cyrus Shahpar & Brian Potts
Managing Editors, CAL/AAEM News Service
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