CMS Proposes Hospital Inpatient Payment Regulation

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.

Certified Inpatient Coder CIC

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 Dick

Executive Editor at AAPC
Michelle A. Dick has been executive editor for AAPC for over seven years. Prior to her work at AAPC, she was editor-in-chief at Eli Research and Element K Journals, and disk ad coordinator, web designer/developer, and graphic artist at White Directory Publishers, Inc. Dick has a Bachelor of Science in Graphic Design from the State University of New York - Buffalo State and is a member of the Flower City Professional Coders in Rochester, N.Y.
Michelle Dick
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About Has 135 Posts

Michelle A. Dick has been executive editor for AAPC for over seven years. Prior to her work at AAPC, she was editor-in-chief at Eli Research and Element K Journals, and disk ad coordinator, web designer/developer, and graphic artist at White Directory Publishers, Inc. Dick has a Bachelor of Science in Graphic Design from the State University of New York - Buffalo State and is a member of the Flower City Professional Coders in Rochester, N.Y.

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