At the end of 2020, the Consolidated Appropriations Act, 2021 was signed into law to provide COVID-19 relief and pass other healthcare related benefits. Starting on January 1, 2023, a new voluntary Medicare designation, Rural Emergency Health (REH) goes into effect for CAHs or PPS hospitals with less than 50 beds. The REH designation was designed for hospitals that cannot support inpatient services any longer. This gives hospitals the ability to increase their outpatient reimbursement by 105% of the current Medicare rates, plus a monthly facility payment for telehealth and ambulance services, ongoing operational expenses, and maintaining facilities.
Rural Emergency Health facilities will need to meet CMS Conditions of Participation regarding CAH emergency services and hospital emergency departments, determined by the Department of Health and Human Services (HHS). REHs can add ambulance services, telehealth, outpatient and observation care, and skilled nursing facility services. The new Consolidated Appropriations Act, 2021 also extended the Rural Community Hospital Demonstration and the Frontier Community Health Integration Project (FCHIP) demonstration by five years. In addition, the law implements Rural Health Clinic (RHC) payment reform and beginning on January 1, 2022, RHCs can start billing for hospice attending physician services.
Specific amounts for the monthly facility payment and final rules have not been released; however, under the right conditions, CAHs that are attached to a health system have the potential to see benefits with a transfer of inpatient stays to other hospitals in the system. If you want to explore the REH in greater detail, we recommend talking to your Medicare Cost Report preparer. If you need further assistance, EqualizeRCM can be your independent guide throughout the process.
Source: Joint Commission