Low Volume Payment Adjustment Deadline Fast Approaching

As provided for by the Pathway for SGR Reform Act of 2013, the Centers for Medicare and Medicaid Services has issued an interim final rule implementing a six-month extension of the low-volume payment adjustment for fiscal year 2014 which extends the adjustment period through March 31, 2014.

To qualify for the low-volume adjustment for discharges occurring prior to April 1, a hospital must: 

• Have fewer than 1,600 Medicare discharges annually
• Be located more than 15 miles from any other IPPS hospital

To receive the adjustment, hospitals must notify and provide documentation to their Medicare Administrative Contractor (MAC) that they meet the 15-mile mileage criterion on or before March 31. CMS has specified the use of Web-based mapping tools, such as MapQuest, as acceptable support documentation for meeting the mileage requirement.

If the mileage requirement has been met, the MAC will verify that the 1,600 discharge requirement has been met by referring to CMS discharge data published in Table 14 of the 2014 Final Rule.

A hospital's notification to their Contractor must be received by the Contractor no later than March 31, 2014.

If you have questions on this interim final rule, please contact your Eide Bailly representative.