CMS released a supplemental proposed rule on May 21, 2010 to implement changes in payments for inpatient services in general acute care hospitals and long term care hospitals (“LTCHS”). The changes are required by the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively, “PPACA”). The proposed rule supplements the 2011 IPPS Proposed Rule described in a blog on April 22. CMS did not have time to address provisions relating to PPACA in the earlier proposed rule. The provisions in the supplemental proposed rule generally take effect for discharges occuring on or after October 1, 2010. As described by CMS, the supplemental proposed rule includes provisions relating to:
- Protection for hospitals in frontier states;
- Additional payments for hospitals with low per enrollee Medicare spending;
- Temporary improvements to the low-volume hospital adjustment;
- Revisions of certain market basket updates;
- Wage index improvement related to geographic reclassification;
- National budget neutrality in the calculation of the rural floor for the hospital wage index;
- Extension of Medicare-dependent hospitals;
- Technical correction related to critical access hospital services;
- Extension of certain payment rules for long term care services and of a moratorium on the establishment of certain hospitals and facilities; and
- Extension of the rural community hospital demonstration program.
You can review a summary of each of these provisions on CMS’S website here. A display copy of the supplemental proposed rule is available here. CMS will accept comments until June 21, 2010.