CMS Finalizes New Medicare Provider Type: Rural Emergency Hospitals

The Centers for Medicare & Medicaid Services finalized a new provider designation for rural hospitals,  “Rural Emergency Hospitals,” in its Outpatient Prospective Payment System rule on Tuesday, November 1. Effective January 1, 2023, this new designation will allow certain eligible rural hospitals and Critical Access Hospital to receive a 5% payment increase for their services.  This new designation is meant to increase payments to rural hospitals to avoid potential closures and provide essential services to their communities. However, under this new designation, the hospitals cannot provide acute inpatient care.

The full text of the final rule is available here:

Written by Catherine B. Moore.

No Surprises Act Update: Louisiana Enforcement

The No Surprises Act “NSA” went into effect January 1, 2022, and protects most consumers enrolled in individual and group health insurance plans from surprise medical bills in certain circumstances.  Enforcement of the NSA generally involves both state and federal governments. The NSA originally allows the states to enforce the provisions of the NSA unless the state is unable to do so. In that scenario, the federal government will enforce the provisions of the NSA in that state.

Based on survey responses and CMS communications between the Centers for Medicare & Medicaid Services and the Louisiana Department of Insurance, “CMS understands that Louisiana lacks authority to enforce the [NSA] provisions.” Therefore, CMS “will assume direct enforcement of these new protections.” Louisiana is one of a handful of states that has deferred enforcement of all provisions of the NSA to the federal government.

We will continue to monitor enforcement of the NSA on a federal level as it relates to enforcement in Louisiana.

Written by Catherine B. Moore.