CHA News Article

OIG Recommends Lower Reimbursement for CAH Swing-Bed Services

A new report from the Department of Health and Human Services Office of Inspector General (OIG) recommends that reimbursement rates for swing-bed services in critical access hospitals (CAH) be reduced to match skilled-nursing facility (SNF) prospective payment system rates. The OIG counsels the Centers for Medicare & Medicaid Services (CMS) to seek legislation to lower the reimbursement rates, and reports that Medicare could have saved approximately $4 billion over a six-year period if the CAH swing-bed services rates were the same as SNF PPS rates. CMS commented on the report, saying it “overestimates savings by failing to incorporate important factors such as the level of care needed by swing-bed patients, transportation fees to alternative facilities, and the use of point-to-point mileage distances instead of road miles.” CHA agrees with CMS’ criticisms calling into question the overall findings and conclusions detailed in the report. CHA continues to advocate for the continued cost-based reimbursement necessary to preserve access to these services to beneficiaries in rural areas.

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