Critical Access Hospital (CAH) Provider Reassignment

Providers performing outpatient services in a Critical Access Hospital (CAH) cannot submit services separately to Part B Medicare when billing reassignment has been signed over to the CAH. The Office of Inspector General (OIG) report identified improper Medicare payments to CAHs and healthcare professionals for the same CAH services.

As stated in CMS Internet Only Manual, Medicare Claims Processing Manual Publication 100-04, Chapter 4, Section 250.2: practitioners must sign an attestation that clearly states that they will not bill Medicare Part B for any services furnished in the CAH outpatient department once the reassignment has been given to the CAH.

CMS MLN Information for Critical Access Hospitals provides correct billing, compliance requirements and references to follow for healthcare professionals providing outpatient services in a CAH.
Source

CMS MLN Connects dated March 23, 2023

 

Last Updated Nov 08 , 2023