CMS to terminate Idaho hospital's Medicare billing privileges

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CMS is ending its provider agreement with Blackfoot-based Idaho Doctors' Hospital July 20, according to KIFI.

Under rules enacted last September, a healthcare facility must average at least two inpatients per day and an at least two-night average length of stay to be considered an inpatient hospital for Medicare reimbursement. Facilities that fall short of these requirements may instead be considered same-day surgery centers, which have different reimbursement rates.

CMS said Idaho Doctors' Hospital doesn't meet the new federal requirements for Medicare participation. In April, CMS determined the hospital does not treat enough inpatients on a daily basis to meet the new requirements.

"To go from being OK just 18 months ago, when we had our last survey, to now being told that we don't meet the CMS conditions of participation because of new interpretations of the regulations is just difficult to comprehend," Dave Lowry, administrative manager at Idaho Doctors' Hospital, told KIFI. "Like any business that is regulated by government agencies, we fully expect there to be changes to rules and their interpretations, but this drastic level of change just goes to show how much uncertainty there is in healthcare right now."

Mr. Lowry told KIFI officials are working with other hospitals to ensure patients have access to the care they need after the Medicare contract is terminated.

"We have great relationships with other hospitals, such as Bingham Memorial Hospital and Eastern Idaho Regional Medical Center, and we are working closely with them to ensure that our patients will continue to receive the essential services that we provide with the exceptional level of care that they have come to expect from our providers."

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