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On July 26, 2022, the Centers for Medicaid and Medicare (“CMS”) published the 2023 Hospital Outpatient Prospective PaymentSystem (OOPS) and Ambulatory Surgery Center PaymentSystem Proposed Rule. One notable difference, however, is that the entity must enroll in Medicare as an REH. Background.
Medicare and Medicaid may have different paymentsystems from those of the private health insurance plans. The lack of documentation may result in an audit, leading to claim denial and fines for noncompliance with Medicare and Medicaid regulations. 2022: $112.29 2021: $103.28 2020: $94.55 between 2020 to 2021.
Announced in the Consolidated Appropriations Act of 2021, Rural Emergency Hospitals (REHs) will be a new type of Medicare provider starting January 1, 2023. Under the OPPS Final Rule, REHs will be paid both on a per-service basis at an OPPS +5% rate and a monthly facility payment.
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