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Sole community hospital

A hospital that is the only one of its kind providing essential healthcare services within a specific geographic area, often located in rural or isolated communities.

Hospital outpatient prospective payment system (OPPS)

The method Medicare uses to pay hospitals for services provided to patients who are not admitted for an overnight stay, such as emergency room visits, clinic visits, or diagnostic tests, based on a predetermined fee schedule.

Covered OPD services

Medical services provided in a hospital's outpatient department that are eligible for payment by Medicare.

Reasonable costs

The expenses that Medicare deems appropriate and necessary for a hospital to provide covered services, excluding costs considered excessive or unnecessary.

Budget neutrality

A principle where any changes to Medicare payments for a group of services should not increase or decrease the total amount of money Medicare spends on those services overall, typically requiring offsetting adjustments.

Secretary

Refers to the Secretary of Health and Human Services, the head of the U.S. Department of Health and Human Services, who is responsible for federal health programs like Medicare.