The Centers for Medicare & Medicaid Services issued its final IPPS rules that will implement a 1.1 percent net increase, compared with FY 2011, in total Medicare operating payments to acute-care hospitals, according to a CMS news release.
In the proposed rule, there would have been a 0.55 percent cut to hospitals' FY 2012 reimbursements, but the final rule will increase payments to hospitals overall by an estimated $1.13 billion. The IPPS for FY 2012 will go into effect Oct. 1, 2011
The following are some of the other major aspects of CMS' final IPPS rule:
• There will be a 2.0 percent cut in FY 2012 for changes in Medicare severity diagnosis related group documentation and coding, opposed to the proposed rule's recommended 3.15 percent cut.
• CMS said a prospective adjustment of a 3.9 percent cut toward documentation and coding continues to be necessary, so while the current 2.0 percent cut handles part of the rate, CMS might consider it feasible to make all or most of the -1.9 percent prospective adjustment in FY 2013.
• A Medicare spending per beneficiary measure will be employed in the Hospital Inpatient Quality Reporting program for FY 2012. This measure will assess Part A and Part B beneficiary spending from three days prior to a hospital admission through 30 days after the patient is discharged. Originally, in the proposed rule, the timeframe was 90 days, but CMS officials decided to keep the IQR program consistent with the 2013 Hospital Readmissions Reduction program.
• The rate-of-increase percentage for IPPS-excluded hospitals such as cancer and children's hospitals will be 3.0 percent.
Read the final rules on the Medicare hospital inpatient prospective payment system (pdf).
Members of U.S. House, Senate Urge CMS to Reconsider IPPS Coding Offset for FY 2012
AHA Wants CMS to Reduce Coding Offset for 2012 IPPS
In the proposed rule, there would have been a 0.55 percent cut to hospitals' FY 2012 reimbursements, but the final rule will increase payments to hospitals overall by an estimated $1.13 billion. The IPPS for FY 2012 will go into effect Oct. 1, 2011
The following are some of the other major aspects of CMS' final IPPS rule:
• There will be a 2.0 percent cut in FY 2012 for changes in Medicare severity diagnosis related group documentation and coding, opposed to the proposed rule's recommended 3.15 percent cut.
• CMS said a prospective adjustment of a 3.9 percent cut toward documentation and coding continues to be necessary, so while the current 2.0 percent cut handles part of the rate, CMS might consider it feasible to make all or most of the -1.9 percent prospective adjustment in FY 2013.
• A Medicare spending per beneficiary measure will be employed in the Hospital Inpatient Quality Reporting program for FY 2012. This measure will assess Part A and Part B beneficiary spending from three days prior to a hospital admission through 30 days after the patient is discharged. Originally, in the proposed rule, the timeframe was 90 days, but CMS officials decided to keep the IQR program consistent with the 2013 Hospital Readmissions Reduction program.
• The rate-of-increase percentage for IPPS-excluded hospitals such as cancer and children's hospitals will be 3.0 percent.
Read the final rules on the Medicare hospital inpatient prospective payment system (pdf).
Related Articles on IPPS:
Big Changes Ahead: Medicare IPPS 2012 and What It Means for HospitalsMembers of U.S. House, Senate Urge CMS to Reconsider IPPS Coding Offset for FY 2012
AHA Wants CMS to Reduce Coding Offset for 2012 IPPS