PAYMENT ADJUSTMENT YEAR 2019 MEDICARE EHR INCENTIVE PROGRAM CRITICAL ACCESS HOSPITAL RECONSIDERATION-2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin with SECTION 1: HOSPITAL INFORMATION. Fill in the required fields marked with an asterisk, including the Legal Hospital Name, CMS Certification Number, and Hospital Address. Ensure accuracy as this information is crucial for processing.
  3. Proceed to SECTION 2: PAYMENT ADJUSTMENT RECONSIDERATION. Indicate whether the hospital has previously demonstrated meaningful use by selecting 'Yes' or 'No'. Then, choose at least one reason for reconsideration from the provided options.
  4. In SECTION 3: CERTIFICATION STATEMENT CONFIRMATION, read through the certification notice carefully. Confirm your understanding by typing your name and date in the designated fields to validate your submission.
  5. Once completed, save your application and attach it to an email addressed to qnetsupport@hcqis.org. Remember to retain a copy for your records before sending.

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Critical Access Hospitals (CAHs) are reimbursed based upon the cost methodology. For Inpatient services, the provider is paid on a per diem basis. For their Outpatient Part B Services, two payment options are available, Method I (Standard Method) and Method II (Optional Method).
To receive federal funding, Critical Access Hospitals must adhere to several guidelines. They may have no more than 25 beds and must have an average duration of hospital stay under 96 hours.
Computing Medicare payments Each CAH receives 101 percent of its costs for outpatient, inpatient, laboratory and therapy services, as well as post-acute care in the hospitals swing beds.
MA contracts: Under traditional Medicare, CAHs are reimbursed at 101% of reasonable and allow- able costs. However, under MA, the basis of payment is negotiated between the MA plans and CAHs. MA plans may offer payment rates above, below, or comparable to traditional Medicare rates.
The Comprehensive Error Rate Testing (CERT) program measures the improper payment rate in traditional Medicare. To determine if claims were paid properly, the CERT program reviews a random sample of traditional Medicare claims approximately 37,500 claims in 2024.

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