CMS seeks rural hospitals' participation in Medicare inpatient demonstration
Demonstration tests feasibility, payment methodology of establishing rural hospitals to provide inpatient services to Medicare beneficiaries.
CMS headquarters-Maryland
The Centers for Medicare and Medicaid Services is accepting applications for its rural community hospital demonstration through Wednesday, May 17.
The demonstration tests the feasibility and payment methodology of establishing rural community hospitals to provide inpatient services to Medicare beneficiaries.
The rural hospitals must have fewer than 51 acute care inpatient beds, make 24-hour emergency care services available, and not be designated as a critical access hospital.
Hospitals participating in the demonstration will receive payment for Medicare inpatient hospital services, except for services furnished in a psychiatric or rehabilitation unit that is a distinct part of the hospital.
Newly-selected hospitals may be located in any state, but priority is given to those located in one of the 20 states with the lowest population densities. These include: Alaska, Arizona, Arkansas, Colorado, Idaho, Iowa, Kansas, Maine, Mississippi, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Utah, Vermont, and Wyoming.
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CMS will develop a participation agreement specifying payment principles, as well as administrative, auditing, and reporting requirements.
The maximum number of hospitals allowed to participate in the budget neutral demonstration is 30.
The rural community hospital demonstration program keeps getting extended for five-year periods, with the most recent being Dec. 13, 2016, due to the 21st Century Cures Act.
Performance periods have ended on a rolling basis from December 31, 2014 through December 31, 2016.
Twenty-one hospitals remained in the demonstration for the duration of their hospital-specific five-year periods for this first extension demonstration.
Hospitals that were participating as of the last day of the initial five-year period, or as of December 30, 2014, are allowed to participate in the new demonstration, CMS said.
CMS is seeking public comment on the proposed rule through June 13 from previously participating hospitals that decide to participate in the extension period.
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"The Request for Applications solicits information from interested hospitals regarding their financial and service-oriented challenges, as well as strategies and proposals for addressing them," CMS said. "We are also asking hospitals to describe the impact of rural hospital closures on the needs of their service area, and problems posed by the need to serve a sparse population."
The first cost reporting period will be on or after October 1, 2017, following the announcement of the selection of additional hospitals.
An evaluation will assess the impact of the demonstration on the financial viability of participating hospitals, as well as their ability to serve the needs of the community.
CMS said it would submit a report to Congress no later than August 1, 2018.
Twitter: @SusanJMorse
