42 C.F.R. 42 CFR--PART 412
Title 42 - Public Health
Effective Date(s): October 1, 2006 20. Section 412.108 is amended by— a. Revising paragraph (a)(1) introductory text. b. Revising paragraph (b)(4). c. Adding a new paragraph (c)(2)(iii). The revisions and addition read as follows: (a) Criteria for classification as a Medicare-dependent, small rural hospital. (1) General considerations. For cost reporting periods beginning on or after April 1, 1990, and ending before October 1, 1994, or for discharges occurring on or after October 1, 1997, and before October 1, 2011, a hospital is classified as a Medicare-dependent, small rural hospital if it is located in a rural area (as defined in subpart D of this part) and meets all of the following conditions: * * * * * (b) * * * (4) A determination of MDH status made by the fiscal intermediary is effective 30 days after the date the fiscal intermediary provides written notification to the hospital. An approved MDH status determination remains in effect unless there is a change in the circumstances under which the status was approved. (i) An approved MDH must notify the fiscal intermediary if any change occurs that is specified in paragraph (b)(4)(ii) of this section occurs. If CMS determines that an MDH failed to comply with this requirement, CMS will cancel the hospital's classification as an MDH effective with the date that the hospital no longer met the criteria for such status, consistent with the provisions of §405.1885 of this chapter. (ii) An MDH must report the following to the fiscal intermediary within 30 days of the event: (A) The number of beds increases to more than 100. (B) Its geographic classification changes. (iii) An MDH must report to the fiscal intermediary if it becomes aware of any change that would affect its classification as an MDH beyond the events listed in paragraph (b)(4)(ii) of this section within 30 days of the event. If CMS determines that an MDH has failed to comply with this requirement, CMS will cancel the hospital's classification as an MDH effective with the date the hospital became aware of the event that resulted in the MDH no longer meeting the criteria for such classification, consistent with the provisions of §405.1885 of this chapter. * * * * * (c) * * * (2) * * * (iii) For discharges occurring during cost reporting periods (or portions thereof) beginning on or after October 1, 2006, and before October 1, 2011, 75 percent of the amount that the Federal rate determined under paragraph (c)(1) of this section is exceeded by the highest of the following: (A) The hospital-specific rate as determined under §412.73. (B) The hospital-specific rate as determined under §412.75. (C) The hospital-specific rate as determined under §412.79. * * * * *
Amendment from August 18, 2006
42 CFR--PART 412
Amendment(s) published August 18, 2006, in 71 FR 48139
§ 412.108 Special Treatment: Medicare-dependent, small rural hospitals.
