The Medicare Access and CHIP Reauthorization Act of 2015 extends the relaxed qualifying criteria for the low volume hospital payment adjustment through September 30, 2017. Under the relaxed criteria, the payment increases are applicable for hospitals that have less than 1,600 Medicare discharges (including traditional and Medicare Advantage) and are located more than 15 road miles from another hospital (excluding critical access, psychiatric, rehabilitation, long-term care, cancer, research and children’s hospitals).

Action Points
Hospitals must notify their Medicare Administrative Contractor if they believe they qualify for the low volume hospital adjustment. Hospitals are required to submit proof that the hospital meets the mileage requirement in order to qualify. Qualification based upon Medicare discharge data will be determined by CMS based on MEDPAR data.

CMS’ deadline to receive a request for this low volume hospital adjustment is September 1, 2015.

If you need help applying for the adjustment, please contact our Albany office at (229) 883-7878 or our Atlanta office at (404) 220-8494.