PURPOSE: This rule establishes the method of payment to be used in computing Medicaid program reimbursement for covered hospital outpatient services provided to General Relief assistance recipients.

1. (1) Effective August 1, 1981, and applying to all services received on or after that date, all outpatient hospital services provided to recipients of General Relief assistance shall be reimbursed by Medicaid in accordance with an established fee schedule. This fee schedule shall be established by the Division of Family Services and shall be based on the reasonable cost to the hospital providing the service. Payment shall not be made for those services which the Division of Family Services may determine are not medically necessary.

AUTHORITY: section 207.020, RSMo 1986.* This rule was previously filed as 13 CSR 40- 81.180. Emergency rule filed July 15, 1981, effective Aug. 1, 1981, expired Oct. 10, 1981. Original rule filed July 15, 1981, effective Oct. 11, 1981. *Original authority: 207.020, RSMo 1945, amended 1961, 1965, 1977, 1981, 1982, 1986.