{"abstract":"This proposed rule would amend the regulatory definition of outpatient hospital services for the Medicaid program. Outpatient hospital services are a mandatory part of the standard Medicaid benefit package. The current regulatory definition at 42 CFR 440.20 is broader than the definition in Medicare, and can overlap with other covered benefit categories. The purpose of this amendment is to align the Medicaid definition more closely to the Medicare definition in order to improve the functionality of the applicable upper payment limits under 42 CFR 447.321 (which are based on a comparison to Medicare payments for the same services), provide more transparency in determining available coverage in any State, and generally clarify the scope of services for which Federal financial participation (FFP) is available under the outpatient hospital services benefit category.","action":"Proposed rule.","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"body_html_url":"https://www.federalregister.gov/documents/full_text/html/2007/09/28/E7-19154.html","cfr_references":[{"chapter":null,"citation_url":null,"part":440,"title":42},{"chapter":null,"citation_url":null,"part":447,"title":42}],"citation":"72 FR 55158","comment_url":null,"comments_close_on":"2007-10-29","correction_of":null,"corrections":[],"dates":"To be assured consideration, comments must be received at one of the addresses provided below, no later than 5 p.m. on October 29, 2007.","disposition_notes":null,"docket_ids":["CMS-2213-P"],"dockets":[],"document_number":"E7-19154","effective_on":null,"end_page":55166,"executive_order_notes":null,"executive_order_number":null,"full_text_xml_url":"https://www.federalregister.gov/documents/full_text/xml/2007/09/28/E7-19154.xml","html_url":"https://www.federalregister.gov/documents/2007/09/28/E7-19154/medicaid-program-clarification-of-outpatient-clinic-and-hospital-facility-services-definition-and","images":{},"images_metadata":{},"json_url":"https://www.federalregister.gov/api/v1/documents/E7-19154?publication_date=2007-09-28","mods_url":"https://www.govinfo.gov/metadata/granule/FR-2007-09-28/E7-19154/mods.xml","not_received_for_publication":null,"page_length":9,"page_views":{"count":2056,"last_updated":"2026-10-23 10:15:04 -0400"},"pdf_url":"https://www.govinfo.gov/content/pkg/FR-2007-09-28/pdf/E7-19154.pdf","presidential_document_number":null,"proclamation_number":null,"public_inspection_pdf_url":null,"publication_date":"2007-09-28","raw_text_url":"https://www.federalregister.gov/documents/full_text/text/2007/09/28/E7-19154.txt","regulation_id_number_info":{"0938-AO17":{"issue":"200810","html_url":"https://www.federalregister.gov/regulations/0938-AO17/medicaid-program-clarification-of-outpatient-hospital-facility-including-hospital-clinic-outpatient-","title":"Medicaid Program; Clarification of Outpatient Hospital Facility (Including Hospital Clinic) Outpatient Services Definition (CMS-2213-F)","xml_url":"http://www.reginfo.gov/public/do/eAgendaViewRule?pubId=200810&RIN=0938-AO17&operation=OPERATION_EXPORT_XML","priority_category":"Other Significant"}},"regulation_id_numbers":["0938-AO17"],"regulations_dot_gov_info":{"checked_regulationsdotgov_at":"2011-11-13T03:46:20Z"},"regulations_dot_gov_url":null,"significant":true,"signing_date":null,"start_page":55158,"subtype":null,"title":"Medicaid Program; Clarification of Outpatient Clinic and Hospital Facility Services Definition and Upper Payment Limit","toc_doc":"Outpatient clinic and hospital facility services; definitions and payment limits","toc_subject":"Medicaid:","topics":["Accounting","Administrative practice and procedure","Drugs","Grant programs-health","Health facilities","Health professions","Medicaid","Reporting and recordkeeping requirements","Rural areas"],"type":"Proposed Rule","volume":72}