Medicare Compliance & Reimbursement

New medical services and technologies could bolster payments.

Hospitals should watch for a number of new diagnosis-related groups and diagnosis and procedure code changes under existing DRGs, as the Centers for Medicare and Medicaid Services turns its attention to rate-of-increase limits and policy changes for hospitals excluded from the inpatient prospective payment system. GME Cost Changes Get A Look In a proposed rule published in the May 4 Federal Register, CMS made the following proposals:
  DRG classification and relative weight annual adjustments, and changes to Medicare payments on graduate medical education costs.
  Wage index revisions based on hospital redesignations, reclassifications and hospital employees who work in a different area with a higher wage index than the area where they reside.
  Revisions to both the hospital operating and capital market baskets. 
  Policy changes relating to critical access hospitals' designation as necessary providers.
  Payment changes for blood clotting factors administered to inpatients with hemophilia.
  A single average standardized operating cost amount.
 
Medicare Addresses MedPAC Suggestions CMS also discusses the Medicare Payment Advisory Commission's March 2005 hospital IPPS recommendations in this proposed rule. MedPAC addressed the IPPS inpatient hospital operating costs and capital-related costs update factor for hospitals excluded from the IPPS.
 
Note: The deadline for comments on the proposed rule is June 24. These proposed changes could become effective for discharges on or after Oct. 1.
 
To read the 2006 IPPS revisions, go online to:
http://a257.g.akamaitech.net/7/257/2422/01jan20051800/edocket.access.gpo.gov/2005/05-8507.htm.