Impact of Medicare Reimbursement Limits on Small Rural Hospitals
HRD-82-109
Published: Aug 06, 1982. Publicly Released: Aug 06, 1982.
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Highlights
In response to a congressional request, GAO reviewed the legislative and regulatory basis for the sole community provider (SCP) exemption to routine inpatient hospital operating cost reimbursement limits, the effect of the SCP exemptions on small rural hospitals, the administration of the SCP exemption program, and a sample of Montana hospital SCP cases to see if all the relevant factors were considered.
Recommendations
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Health and Human Services | The Secretary of HHS should direct the Administrator of the Health Care Financing Administration (HCFA) to eliminate exempted providers from computations of expected savings that will result from the reimbursement limits. |
Closed – Not Implemented
Congress, in enacting a prospective Medicare payments system, eliminated the reimbursement limits for hospitals after 1986. Accordingly, this recommendation would only apply until 1986.
|
| Department of Health and Human Services | The Secretary of HHS should direct the Administrator of HCFA to define key terms and provide intermediary and HCFA regional office staff with a method of evaluating key factors used to determine if a hospital is entitled to an SCP exemption. |
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
|
| Department of Health and Human Services | The Secretary of HHS should direct the Administrator of HCFA to redefine the group size and establish new limits for small rural hospitals to ensure that the limits affect such hospitals equitably. |
Closed – Not Implemented
The Tax Equity and Fiscal Responsibility Act of 1982 exempted small rural hospitals from the cost limits but instead subjected them to cost growth ceiling. Accordingly, the recommendation is no longer valid.
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Topics
Eligibility criteriaHealth care cost controlRural hospitalsHealth care costsHealth care servicesHealth resources utilizationHospital bed countMedicareRural areasHospitals