President Bush today signed an Iraq war spending bill that includes a moratorium delaying six Medicaid rules until April 2009. Congress last week approved the AHA-supported moratorium, which delays rules covering certified public expenditures, intergovernmental transfers and graduate medical education that would have a dramatic impact on hospitals, as well as rules affecting state provider tax laws, case management services, rehab services and school outreach. Congress excluded from the moratorium a proposed Medicaid rule that would narrowly define hospital outpatient services, jeopardizing community-based services such as screening, diagnostic and dental services for children as well as lab and ambulance services. AHA continues to oppose the Medicaid outpatient rule.