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AHA criticizes OIG proposal to remove, reevaluate certain CAHs' status

August 15, 2013

The AHA today took issue with a new report from the Department of Health and Human Services’ Office of Inspector General that recommends dramatic changes to the critical access hospital program. Specifically, the report recommends that the Centers for Medicare & Medicaid Services seek legislative authority to remove the permanent exemption from the distance requirement for “necessary provider” CAHs and revise the CAH Conditions of Participation to include alternative location-related requirements, claiming that 64% of the nation’s 1,329 CAHs would not meet the current location requirements if required to re-enroll in Medicare. It also recommends that CMS periodically reassess CAHs for compliance with all location-related requirements, and apply its uniform definition of “mountainous terrain” to all CAHs. Joanna Hiatt Kim, AHA vice president of payment policy, said, “The OIG’s recommendation that CMS seek legislative authority to remove and reevaluate certain CAHs’ special Medicare status is completely inappropriate and demonstrates an unfortunate lack of understanding of how health care is delivered in rural America. If the recommendation were implemented, many of these facilities may be forced to close and patients could lose their access to essential medical services.”