Drafted in response to a new state statute that blocks public funding of abortions, the rule establishes an accounting method for hospitals to prove that only "non-public" funds paid for early delivery of a fatally deformed fetus.

After a heated public hearing last month, Health Department Director Scott Williams asked department attorneys to rework the rule's definition of "public funds" and "gift or donor provided funds." Williams says the rule has been simplified to eliminate confusion.

But the changes are not enough to satisfy critics who believe the State Health Department is whittling away at Senate Bill 68, new abortion restrictions that lawmakers approved during the 2004 Legislature.

"I'm extremely suspicious of this new ruling," said Daniel Newby, a volunteer with the conservative lobbying group Accountability Utah.

The law prohibits direct or indirect public funding of abortions, except in cases of rape, incest or damage to a "major bodily function" of the mother. Doctors and hospitals afraid of losing reimbursement for Medicaid and Children's Health Insurance Program patients changed their policies when the law went into effect May 3 to send pregnant mothers diagnosed with fatal fetal defects to three Salt Lake City women's clinics for abortions. Later that month, a Roy family was turned away by nervous doctors at McKay-Dee Hospital.

Health Department attorneys first published rules clarifying the law and giving hospitals a mechanism to perform early terminations July 1.

Newby believes the amended rule does not account for public money used to build state hospital buildings, pay doctors or nurses employed at those clinics or cover overhead costs like heating and cooling. And he questions Health Department employees' commitment to enforcing the law.

"What incentive does the Department of Health have to make sure that things are followed correctly?" Newby asked. "Who's going to make sure that they comply?"

But Assistant Attorney General Doug Springmeyer says hospitals will be required to provide their own accounting of overhead costs and prove that public funds do not subsidize any prohibited abortions.

And Springmeyer noted that state Medicaid auditors have reviewed Health Department payments for abortion three times in the last five years, taking payments back from doctors when they determined a procedure was not allowed under strict federal abortion laws.

Employees who improperly approve reimbursement can be fired.

The original public comment period on the rule expired at the beginning of August. The amended rule's publication in the Sept. 1 Utah State Bulletin starts another 30-day public comment period. Newby said Accountability Utah probably will request another public hearing on the revised rule.

Meantime, an emergency rule remains in place until Oct. 7.