August 27, 2014

Acute Inpatient PPS Final Rule

Acute Inpatient PPS Final Rule

In the August 22, 2014 Federal Register, the Centers for Medicare and Medicaid Services (CMS) issued CMS-1607-F. This Final Rule revises the Medicare hospital inpatient prospective payment systems (IPPS) for payments to acute care hospitals for discharges occurring on or after October 1, 2014. The Final rule also included certain important changes from the Proposed Rule relating to the Connecticut rural wage index.

In addition, some of the other highlights included in the Final Rule are as follows:

  • An update to the rate of increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits.
  • An update to the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) and implementing certain statutory changes to the LTCH PPS under the Affordable Care Act and the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013 and the Protecting Access to Medicare Act of 2014.
  • A number of changes relating to direct graduate medical education (GME) and indirect medical education (IME) payments.
  • An update to policies relating to the Hospital Value-Based Purchasing (VBP) Program, the Hospital Readmissions Reduction Program, and the Hospital-Acquired Condition (HAC) Reduction Program.
  • Alignment of the reporting and submission timelines for clinical quality measures for the Medicare EHR Incentive Program for eligible hospitals and critical access hospitals (CAHs) with the reporting and submission timelines for the Hospital IQR Program.
  • This document finalizes two interim final rules with comment period relating to criteria for disproportionate share hospital uncompensated care payments and extensions of temporary changes to the payment adjustment for low-volume hospitals and of the Medicare-Dependent, Small Rural Hospital (MDH) Program.

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