House crafts bill that focuses on CAHs' 96-hour rule

A bill introduced in Congress would eliminate some of the length-of-stay burdens critical access hospitals have to bear in order to get paid under Medicare Part A, according to AHA News Now.

The bill, which has bipartisan support in the U.S. House of Representatives, focuses on the 96-hour rule. Under current regulations, patients admitted to a CAH who likely require a long stay must have a physician certify that they transfer to another hospital within 96 hours of admission in order for the CAH to collect payment.

The Centers for Medicare & Medicaid Services' recent rule regarding the two-midnight rule for inpatient admissions apparently would include tighter enforcement for the CAH 96-hour rule, which is not rigorously enforced, according to AHA News Now.

CAHs are small (25 beds or under), remote facilities located almost exclusively in rural areas and receive extra funding from the federal government in order to help keep their doors open. However, there are proposals to radicaly change how the government funds CAHs. One of the proposals currently floated by the Office of the Inspector General of the U.S. Department of Health and Human Services would use a digital mapping process to locate all currently eligible CAHs in order to determine if they meet all the criteria for program participation. If implemented, the proposal may disqualify as many as  two-thirds of participating facilities from the CAH program.

Under the bill, which is sponsored by Adrian Smith (R-Neb.), Greg Walden (R-Ore.), Lynn Jenkins (R-Kan.) and David Loebsack (D-Iowa), the physician certification would no longer be required, although CAHs would still need to verify that their patients had annual average lengths of stay that are under the 96-hour threshold.

To learn more:
- read the AHA News Now article

 

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