sole community hospital

0000006173 00000 n The hospital must make its request to its fiscal intermediary. 0000083855 00000 n Section 412.92. Medicare Claims Processing Manual (Pub. Any questions pertaining to the license or use of the CPT must be addressed to the AMA. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL COVERED BY THIS LICENSE. (3) Adjustment to payments.

(2) The hospital is located between 15 and 25 miles from other like hospitals but because of local topography or periods of prolonged severe weather conditions, the other like hospitals are inaccessible for at least 30 days in each 2 out of 3 years. 0000009286 00000 n 0000034140 00000 n

End users do not act for or on behalf of the CMS. 0000030676 00000 n


Sole Community Hospital status is effective 30 days after the date of CMS’s written notification of approval.  When a court order or a determination by the PRRB reverses an CMS denial of SCH status and no further appeal is made, the SCH status is effective as follows:

The updated hospital-specific rate based on FY 2006 costs per entities.

To be eligible to participate in the 340B Drug Pricing Program, Sole Community Hospitals … OHSU brings you safe, excellent care — in person and in virtual visits. (3) Effective for cost reporting periods beginning before October 1, 2017, the MAC determines a lump sum adjustment amount not to exceed the difference between the hospital's Medicare inpatient operating costs and the hospital's total DRG revenue for inpatient operating costs based on DRG-adjusted prospective payment rates for inpatient operating costs (including outlier payments for inpatient operating costs determined under subpart F of this part and additional payments made for inpatient operating costs for hospitals that serve a disproportionate share of low-income patients as determined under § 412.106 and for indirect medical education costs as determined under § 412.105). The MAC reviews the request and sends the request, with its recommendation to the appropriate CMS Regional Office. License to use CDT-4 for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. Any questions pertaining to the license or use of the CDT-4 should be addressed to the ADA.

(e) Additional payments to sole community hospitals experiencing a significant volume decrease. (i) In determining the adjustment amount, the MAC considers -.
is located in a rural area AND it meets ONE of the following Sole Community Hospital (SCH) Under the acute care hospital inpatient prospective payment system, special payment protections are provided to a SCH. For the mileage and rural location criteria in paragraph (a) of this section and the mileage, accessibility, and travel time criteria specified in paragraphs (a)(1) through (3) of this section, the hospital must demonstrate that the main campus and its remote location(s) each independently satisfy those requirements.

Contact. CPT is a trademark of the AMA. 0000143238 00000 n (iii) For Federal fiscal year 2003, the hospital-specific rate is the sum of 25 percent of the greater of the amounts specified in paragraph (d)(1)(i), (d)(1)(ii), or (d)(1)(iii) of this section, plus 75 percent of the hospital-specific rate as determined under § 412.77.

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