Critical Access Hospitals (CAH). The MCO is encouraged, but not required, to Contract with Critical Access Hospitals (CAH) for inpatient and outpatient hospital services
Critical Access Hospitals (CAH). Unless specifically noted elsewhere in this Agreement, the provisions in this subsection set forth below shall govern the pricing of all services provided to State Health Plan Members under this Agreement in a critical access hospital.
a. For inpatient services, 200%, and for outpatient services, 235% of rate paid to the CAH under original Medicare at the time the claim is processed.
b. Any components of a CAH claim that are priced by Medicare based on 101% of the CAH’s “reasonable cost” CAH claims will be paid based solely on the interim rate(s) in effect at the time the claim is processed and will not be subject to a final settlement after the applicable cost reports are filed.
