![]() REHs would be paid for furnishing REH services at a rate that is equal to the OPPS payment rate for the equivalent covered outpatient department service increased by 5%. To improve access to all types of care in rural settings, CMS is proposing to consider all covered outpatient department services (that is, services that would otherwise be paid under the OPPS) as REH services. After the initial payment is established in CY 2023, the payment amount will increase in subsequent years by the hospital market basket percentage increase. REHs will also receive a monthly facility payment. Beneficiaries will not be charged coinsurance on the additional 5% payment. Covered outpatient department services provided by REHs will receive an additional 5% payment for each service. Together, the policies in these proposed rules will allow rural hospitals to seek this new designation and provide continued access to emergency services, observation care, and additional medical and outpatient services.īy statute, REH services include emergency department services, observation care, and may include other outpatient medical and health services as specified by the Secretary. In this rule, CMS is proposing the provider enrollment procedures and payment rates that would apply to REHs. On JCMS published a rule proposing the Conditions of Participation (CoPs) for Rural Emergency Hospitals. REHs are facilities that convert from either a CAH or a rural hospital (or one treated as such under section 1886(d)(8)(E) of the Social Security Act) with less than 50 beds, and that do not provide acute care inpatient services with the exception of skilled nursing facility services furnished in a distinct part unit. Section 125 of the Consolidated Appropriations Act, 2021 (CAA) established a new Medicare provider type called Rural Emergency Hospitals (REHs), effective January 1, 2023. There has been a growing concern that closures of rural hospitals and critical access hospitals (CAHs) are leading to a lack of services for people living in rural areas. Rural Emergency Hospitals: Payment Policies This update is based on the projected hospital market basket percentage increase of 3.1%, reduced by 0.4 percentage point for the productivity adjustment. The proposed update applies to ASCs meeting relevant quality reporting requirements. Using the proposed hospital market basket update, CMS is proposing to update the ASC rates for CY 2023 by 2.7%. ![]() In the CY 2019 OPPS/ASC final rule with comment period, CMS finalized the proposal to apply the productivity-adjusted hospital market basket update to ASC payment system rates for an interim period of 5 years (CY 2019 through CY 2023). In accordance with Medicare law, CMS is proposing to update OPPS payment rates for hospitals that meet applicable quality reporting requirements by 2.7%. This fact sheet discusses the major provisions of the proposed rule (CMS-1772-P), which can be downloaded at. ![]() CMS is publishing this proposed rule to meet the legal requirements to update Medicare payment policies for OPPS hospitals and ASCs on an annual basis. The proposed policies will affect 3,411 hospitals and approximately 5,500 ASCs. The proposed rule would further the agency’s commitment to strengthening Medicare and use the lessons learned from the COVID-19 PHE to inform the approach to quality measurement. In addition to proposing payment rates, this year’s rule includes proposals that align with several key goals of the Administration, including advancing health equity in rural areas, promoting competition in the health care system, and promoting safe, effective, and patient-centered care. The final rule will be issued in early November. On July 15, 2022, the Centers for Medicare & Medicaid Services (CMS) proposed Medicare payment rates for hospital outpatient and Ambulatory Surgical Center (ASC) services. The calendar year (CY) 2023 Hospital Outpatient Prospective Payment System (OPPS) and ASC Payment System Proposed Rule is published annually and will have a 60-day comment period, which will end on September 13, 2022.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |