Change In Tricare Reimbursement for Sole Community Hospitals

InsightsClient Alert

Effective October 7, 2013, TRICARE will reimburse sole community hospitals (SCHs) the higher of the DRG-based amount for inpatient services or an amount approximating the SCH’s costs as determined by applying the most recent Medicare cost-to-charge ratio (CCR) to charges. Labor/delivery and nursery DRGs will be reimbursed 130% of the Medicare CCR. The Medicare CCR used is the sum of Medicare’s operating and capital CCRs so SCHs will not need to file requests for capital cost reimbursement.

 

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