This provision specifies that reimbursement for outpatient clinical diagnostic laboratory services provided by CAHs are based on reasonable costs and that Medicare beneficiaries are not liable for any cost-sharing amount for these services.
Professional fees are subject to the physician fee schedule.
This provision allows CAHs that elect the all-inclusive rate to now be paid a facility fee based on reasonable costs plus an amount based on 115 percent of the physician fee schedule for professional services. The BBA requires the Secretary to develop an appropriate manner to apply SNF PPS to hospitals and CAHs with swing beds, after the SNF PPS transition period, which ends in 2002. Swing bed services are currently paid on a reasonable cost basis, subject to limits. Swing beds in CAHs are exempt from the SNF PPS, and are paid for covered SNF services on a reasonable cost basis. This provision requires the Secretary to recognize as reasonable costs amounts for the compensation and related costs for on-call emergency room physicians who are not present on the critical access hospital premises, are not otherwise furnishing services, and are not on call at any other provider or facility.