(a) Purpose. This subpart implements section 1886(g)(1)(A) of the Act by establishing a prospective payment system for inpatient hospital capital-related costs. Under this system, payment is made on the basis described in § 412.304 through § 412.374 for inpatient hospital capital-related costs furnished by hospitals subject to the prospective payment system under subpart B of this part.
(b) Definition. For purposes of this subpart, a new hospital means a hospital that has operated (under previous or present ownership) for less than 2 years. The following hospitals are not new hospitals:
(1) A hospital that builds new or replacement facilities at the same or another location even if coincidental with a change of ownership, a change in management, or a lease arrangement.
(2) A hospital that closes and subsequently reopens.
(3) A hospital that has been in operation for more than 2 years but has participated in the Medicare program for less than 2 years.
(4) A hospital that changes its status from a hospital that is excluded from the prospective payment systems to a hospital that is subject to the capital prospective payment systems.
[56 FR 43449, Aug. 30, 1991, as amended at 57 FR 39827, Sept. 1, 1992]
Notes of Decisions
Select Specialty Hosp.-Bloomington, Inc. v. Sebelius, 774 F. Supp. 2d 332 (D.D.C. 2011).
· cites it 27× “This case concerns one critical issue: whether plaintiffs were “new hospitals” under 42 C.F.R. § 412.300 (b) for capital-cost reimbursement during their “start-up eost[-] reporting periods.”
Select Specialty Hosp.—Bloomington, Inc. v. Burwell, 757 F.3d 308 (D.C. Cir. 2014).
· cites it 6× “1, 1992); see also 42 C.F.R. § 412.300 (b). About a year after the scheme was established, the following language was added to the existing regulations: The following hospitals are not new hospitals: (1) A hospital that builds new or replacement facilities at the same or another…”
Select Specialty Hosp. - Bloomington, Inc. v. Sebelius, 893 F. Supp. 2d 1 (D.D.C. 2012).
· cites it 5× “§ 706 , against Health and Human Services (“HHS”) Secretary Kathleen Sebelius (“defendant” or the “Secretary”), challenging the Provider Review and Reimbursement Board’s (the “Board”) determination that plaintiffs were not “new hospital[s]” under 42 C.F.R. § 412.300 (b). On…”
Select Specialty Hosp. - Bloomington, Inc. v. Sebelius (D.D.C. 2011).
· cites it 18× “This case concerns one critical issue: whether plaintiffs were "new hospitals" under 42 C.F.R. § 412.300 (b) for capital-cost reimbursement during their "start-up cost[-] reporting periods.”
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