CRITICAL ACCESS HOSPITALS PERMITTED TO ESTABLISH PSYCHIATRIC AND REHABILITATION UNITS
The Centers for Medicare & Medicaid Services today issued instructions that will make it easier for Medicare beneficiaries in rural areas to receive inpatient rehabilitation and psychiatric services in facilities near their homes. The instructions, which implement Section 405(g) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, allow critical access hospitals (CAHs) to set aside units of up to ten beds each to be used exclusively for inpatient rehabilitation and psychiatric services.
These units, which would not count toward the CAH's 25-bed maximum, will be paid as if they were distinct parts of acute care hospitals, and will have to meet the same standards as units in acute care hospitals. This means Medicare will pay for inpatient rehabilitation services in a CAH unit based on the Inpatient Rehabilitation Facility Prospective Payment System. Medicare will pay for inpatient psychiatric services on a reasonable cost basis, until a new prospective payment system for inpatient psychiatric facilities is implemented.
"We believe critical access hospitals have an important role to play in making it possible for patients to receive inpatient rehabilitation and psychiatric services in their communities," said CMS Administrator Mark B. McClellan, M.D., Ph. D. "This new assistance from the Medicare law is especially important for elderly beneficiaries in rural areas, whose support network of family and friends might otherwise find it difficult to visit."
Critical access hospitals are limited-service hospitals located in rural areas that receive cost-based reimbursement. To be certified by Medicare as a critical access hospital, a facility must, among other requirements: (1) be located in a county or equivalent unit of a local government in a rural area; and (2) be located more than a 35-mile drive from a hospital or another health care facility; or be certified by the State as being a necessary provider of health care services to residents in the area.
Earlier this year, CMS implemented several other provisions of the Medicare Modernization Act that will help critical access hospitals as they serve rural beneficiaries. These hospitals can now designate up to 25 beds as either acute care beds or swing beds beds that may be used for either acute or post-acute care. In addition, payment for both inpatient and outpatient services rendered by critical access hospitals was increased from 100 percent to 101 percent of reasonable costs.