Twenty-five members of the U.S. House of Representatives are seeking clarity on whether HHS plans to enforce Medicare's 96-hour payment rule and condition of participation for critical access hospitals after the COVID-19 public health emergency ends.
The rule requires critical access hospitals to certify inpatients will be charged or transferred to another hospital within 96 hours of admission to receive payment, according to the letter sent to HHS Secretary Xavier Becerra on July 21. A related Medicare condition requires that inpatient stays remain below 96 hours on an annual average basis.
HHS has not prioritized the enforcement since 2018 because of the financial burden it posed to critical access hospitals, according to the letter. In 2020, HHS waived the condition of participation as part of the COVID-19 public health emergency, which was recently extended through Oct. 13.
If reinstated, the members of Congress want to know if there will be a grace or phase-in period before penalties are applied. They are also asking if Mr. Becerra supports legislative efforts to repeal either or both of the 96-hour conditions.
The members are seeking Mr. Becerra's response in writing by Sept. 9.