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CMS Issues New Requirements for Hospital Emergency Services and Proposed Hospice Wage Index Rule


Email Alert

April 27, 2007

On April 26, 2007, CMS released new guidance on requirements for all hospitals (including specialty hospitals) that provide emergency services and are Medicare providers. In addition, CMS issued its proposed rule for the FY 2008 hospice wage index.

New Requirements for Hospitals Providing Emergency Services

On April 26, 2007, the Centers for Medicare & Medicaid Services (CMS) issued guidance clarifying the responsibility of hospitals to provide emergency services if they participate in the Medicare program. The guidance makes it clear that nearly all hospitals—including specialty hospitals and others without emergency departments—must be able to evaluate persons with emergencies, provide initial treatment, and refer or transfer these individuals when appropriate. The guidance does not apply to critical access hospitals (CAHs), which are small, rural hospitals that are subject to separate regulation.

The guidance was issued in a Survey and Certification letter. Survey and Certification letters guide State Agency surveyors in determining whether hospitals meet all conditions of participation required to participate in the Medicare program. The letter reiterates Medicare's long-standing requirement that hospitals have appropriate policies and procedures in place to address individuals' emergency care needs 24 hours per day, 7 days per week.

There are three key requirements for a hospital: (a) the capability to appraise the emergency situation, (b) providing initial treatment, and (c) referral when appropriate. The letter clarifies that the Medicare Conditions of Participation (CoPs) do not permit a hospital to rely upon 9-1-1 services as a substitute for the hospital's own ability to provide these services.

For more information on CMS' new requirements, please view the CMS letter. You can also see CMS' press release announcing the new guidance.

Proposed Hospice Wage Index Rule

On April 26, 2007, CMS placed its proposed hospice wage index rule on display at the Office of the Federal Register. The rule is expected to be published in the Federal Register on May 1, 2007. Comments are due by July 2, 2007. The final rule will be published in time to be effective for fiscal year 2008 beginning October 1, 2007.

To see the proposed rule on display at the Office of the Federal Register, click here. When published in the Federal Register, the final rule will be posted here.

For more information about CMS' contingency plan and enforcement of the NPI regulations, click here. More information and education on the NPI can be found at the CMS NPI web page.

We would like to thank Jim Flynn (Bricker & Eckler LLP, Columbus, Ohio) for providing this email alert.

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