Description:-

Critical Access Hospitals have special Conditions of Participation.  This webinar provides a step-by-step review of the CAH CoPs including discussions of special situations.  Additionally, PPS hospital CoPs are compared and contrasted to CAH CoPs.  As appropriate, auditing guidelines will be discussed such as ER services and observation services utilizing the State Operations Manual.

Teleconference/Webinar Objectives:

• To review 42 CFR § 485 – CAH CoPs
• To understand terminology and requirements for CAHs
• To appreciate special COPs and how they differ from PPS hospitals.
• To understand special requirements for physicians and practitioners.
• To have knowledge of special concerns about EMTALA.
• To appreciate how the provider-based rule (PBR) affects CAHs.
• To understand the requirements for physician supervision.
• To understand the requirements for utilization review.
• To understand the need to at least annually review the CoPs for compliance.
• To review current problems with the CoPs and on-going guidance.

Objectives of the Session:

• To review 42 CFR § 485 – CAH CoPs
• To understand terminology and requirements for CAHs
• To appreciate special COPs and how they differ from PPS hospitals.
• To understand special requirements for physicians and practitioners.
• To have knowledge of special concerns about EMTALA.
• To appreciate how the provider-based rule (PBR) affects CAHs.
• To understand the requirements for physician supervision.
• To understand the requirements for utilization review.
• To understand the need to at least annually review the CoPs for compliance.
• To review current problems with the CoPs and on-going guidance.

Agenda for the session Part 1:

• Overview
  • Critical Access Hospitals
  • Cost-Based Reimbursement
  • Organizational Structuring Requirements
  • Cost-Reporting Process
• CAH CoPs
  • Overview
  • Comparison to PPS Hospital CoPs
  • State Operations Manual & Audit Information
• Review of CAH CoPs
  • Definitions and Terminology
  • Rural Networks
  • Personnel and Personnel Qualification
  • Status, Location, Certification, and Accreditation
  • Emergency Services
  • Physical Plant
  • Organization and Staffing.

Agenda for the session Part 2:

• Services and Clinical Records
• Periodic Reviews and Quality
• Physician Credentialing
• Utilization Review
• Telehealth Services

• Special Related Issues
  • EMTALA
  • Conditions for Payment (CfPs)
  • Provider-Based Rule
  • Observation and IP Status
  • Physician Supervisory Requirements
  • Non-Physician Practitioners
• Sources for Further Information

Prerequisites for Participating:  General knowledge of Critical Access Hospitals and hospital compliance in general.

Who will be benefits:

CAH Coding Personnel, Billing and Claims Transaction Personnel, Nursing Staff, Outpatient Service Area Personnel, Chargemaster Coordinators, Financial Analysts, Compliance Personnel, Physicians, Practitioners and Other Interested Personnel.