Section 148 of The Medicare Improvements for Patients and Providers Act (MIPPA)

CR 6395 announces a change in the payment methodology for Critical Access Hospitals (CAHs) submitting claims for certain outpatient clinical diagnostic laboratory tests.

Effective for services furnished on or after July 1, 2009 a CAH will be paid 101 percent of reasonable costs for outpatient clinical diagnostic laboratory tests, and the individual is no longer required to be physically present in a CAH at the time the specimen is collected. However, the individual must be an outpatient of the CAH, and be receiving services directly from the CAH. In order for the individual to be receiving services directly from the CAH, the individual must either be receiving outpatient services in the CAH on the same day the specimen is collected, or the specimen must be collected by an employee of the CAH or an entity that is provider-based to the CAH.