CMS has issued a display copy of its 2011 Inpatient Prospective Payment System Proposed Rule. CMS proposes to update payment rates to general acute care hospital by 2.4% to adjust for inflation, but apply a -2.9% Documentation and Coding Adjustment (DCA). The DCA would continue CMS’s efforts to adjust payments to account for changes in documentation and coding practices after the adoption of the MS-DRG system. Such changes in coding practices resulted in higher aggregate payments that did not reflect an actual increase in patient severity of illness. CMS is phasing in the DCA adjustments over time. Overall, CMS estimates that after these proposed changes to the payment rates and other factors, the Proposed Rule would cause a 0.1% drop in total payments made to general acute care hospitals for operating expenses. A few other highlights from the Proposed Rule include:
- Proposed additional quality measures for hospitals to report under the Reporting Hospital Quality Data for Annual Payment Update program.
- Proposed changes to Medicare’s hospital conditions of participation regarding the types of practitioners who may provide rehabilitation services and respiratory care services.
- Proposed changes concerning effective dates for provider agreements and supplier approvals.
- Proposed clarifications concerning whether certain taxes are considered allowable costs.
CMS also proposes to update long-term care hospital (LTCH) rates by 2.4% for inflation, but apply a -2.5% DCA. Overall, CMS expects that after these proposed changes and others, total payments to LTCHs to increase by 0.8%.
CMS notes that it did not have time to address provisions in the Patient Protection and Affordable Care Act enacted on March 23, 2010. CMS, however, will issue separate proposed rules relating to provisions of the Act. Comments to the Proposed Rule are due by June 18, 2010. You can review CMS’s display copy here and summaries from CMS here and here.