Medicare Compliance & Reimbursement

CMS tries to set the record straight regarding its proposed rule.

Your hospital payments could actually increase under the Centers for Medicare & Medicaid Services' (CMS) new proposed rule, despite lawmakers' anxiety about the rule's ground-shaking changes and rushed implementation dates.

CMS didn't officially respond to House and Senate lawmakers' concerns regarding the agency's proposed rule that would change the Medicare Inpatient Prospective Payment System (IPPS) significantly (see related article on page 1), but it did release a fact sheet on July 17 about the hospital payment changes. "The new regulations will not reduce the total amount of money that Medicare pays annually to reimburse hospitals," CMS explains in the fact sheet. "In fact...payments to all hospitals will increase by 3.4 percent for FY 2007," the agency adds.

Payments for patients with more complicated conditions and those who are severely ill will increase under the new regs, CMS also points out in the fact sheet. "For example, payments for hospitals treating patients with simple pneumonia with complications would increase by 10.6 percent, and payments for patients with chronic obstructive pulmonary disease would increase by 10.8 percent." But payments for inpatients receiving pacemakers would decrease by 9.6 percent "because of high mark-up for the ancillary services related to this diagnosis," the agency says.

The final regulation, which CMS says it will issue in a few weeks, will address comments and steps to limit the proposed rule's short-term impact on hospitals.

The fact sheet is available at www.cms.hhs.gov/apps/media/press/release.asp?Counter=1899.