CMS Proposes Hospital Inpatient Payment Regulation

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  • May 1, 2014
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April 30, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update 2015 Medicare payment policies and rates for inpatient stays at general acute care and long-term care hospitals (LTCHs).
CMS projects the payment rate update to general acute care hospitals will be 1.3 percent in 2015, and the rate update for long-term care hospitals will be 0.8 percent. “The difference in the update is accounted for by different statutory and regulatory provisions that apply to each system,” according to an April 30 CMS press release.
The rule’s most significant changes are:

  • Payment provisions intended to improve the quality of hospital care and reduce payment for readmissions and hospital acquired conditions.
  • Proposed changes to the Hospital Inpatient Quality Reporting (IQR) Program.
  • Explanation of how hospitals can comply with the Affordable Care Act’s requirements to disclose charges for their services online or in response to a request, supporting price transparency for patients and the public.

CMS Administrator Marilyn Tavenner said, “This proposed rule is geared toward improving hospital performance while creating an environment for improved Medicare beneficiary care and satisfaction.”
The proposed rule wants public input on an alternative payment methodology for short stay inpatient cases that may be treated as outpatient basis. Stakeholders should be aware of existing processes for requesting additional exceptions to the two-midnight benchmark.
For more information on the payment and quality provisions in the proposed hospital inpatient prospective payment system (IPPS)/LTCH PPS rule, go to the CMS Payments page and the Quality Fact Sheet.

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Michelle Dick
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Michelle A. Dick, BS, is a freelance content specialist, providing writing, editorial expertise, and graphic imagery to clients. Prior to becoming a free agent, she was an executive editor for AAPC, editor-in-chief at Eli Research, and editor at Element K Journals. After earning a Bachelor of Science from the State University of New York at Buffalo State, Dick entered the publishing industry as a graphic artist, ad coordinator, and web designer for White Directory Publishers, Inc.

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