CMS Implements Reimbursement Program for Emergency Medical Care
Delivered to Undocumented Aliens
CAL/AAEM News Service
calaaem_news at yahoo.com
Sun May 22 22:47:30 PDT 2005
CMS Implements Reimbursement Program for Emergency Medical Care Delivered to Undocumented
Aliens
Source: Kathleen A. Ream, Director, Government Affairs, AAEM (http://www.aaem.org)
Date: May 10, 2005
The Centers for Medicare & Medicaid Services (CMS) yesterday announced a new program to
provide $1 billion over four years to help hospitals, certain physicians, and ambulance
providers recoup the costs of providing needed emergency medical care.
Section 1011, Federal Funding of Emergency Health Services Furnished to Undocumented, of
the Medicare Prescription Drug, Improvement, and Modernization Act set aside $1 billion
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, certain 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.
In implementing the new program, CMS will make payments to eligible providers for some or
all of their unreimbursed costs of providing emergency health care services required
under EMTALA and related hospital inpatient, outpatient and ambulance services. Since
under EMTALA hospitals with emergency rooms are required to treat and stabilize patients
who present with emergency medical needs regardless of their ability to pay, the cost of
this unfunded mandate has put considerable strains on hospital budgets.
The actual notice will be published in the Federal Register on or about May 13, 2005.
CMS policy notice and related documents can be viewed now by going to:
http://www.cms.hhs.gov/providers/section1011/
Cyrus Shahpar & Brian Potts
Managing Editors, CAL/AAEM News Service
UC-Irvine
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