Medicare Compliance & Reimbursement

Proposed rule answers call for fee updates, policy changes.

Good things are in store for long-term care hospitals.

LTCHs are looking at a 2.9 percent boost in Medicare pay starting July 1, 2004, with a forecast for total reimbursement increases to reach $2.33 billion in 2005, the Centers for Medicare & Medicaid Services revealed Jan. 23.

Hospitals will see the new federal rates ramped in with their own costs over a five year period, but will be offered a one-time, irrevocable opportunity to move to the full federal PPS payment rate during the phase-in.

CMS also proposes expanding the existing interrupted stay policy; allowing satellite locations to qualify as separate certified long-term care hospitals; and revising the procedure for calculating a hospital's average length of stay for purposes of qualifying for payment under the LTCH PPS.

CMS will not change the LTCH diagnosis-related groups and relative weights until the hospital IPPS update on October 1, 2004.

The proposed rule will be published in the January 30 issue of the Federal Register, with a final rule expected this spring.

Lesson Learned:  Long-term care facilities can expect more funding and better options from CMS this year.