Corporate Compliance

CMS issues final inpatient payment (IPPS) rules for acute-care hospitals

Compliance Monitor, August 4, 2004

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CMS issued its final fiscal year 2005 inpatient payment rules August 3, pledging to increase reimbursement to acute-care hospitals, offer additional financial relief to rural hospitals, and create a link between quality and payment.

According to CMS, the combined impact of the inflation update and other proposed changes-required by the Medicare-reform law-will yield an average 5.7% increase in payments for urban hospitals next year. Rural hospitals will see an average increase of 6.2%.

Medicare payments to approximately 3,900 acute-care hospitals under the inpatient prospective payment system (IPPS) are projected to be $105 billion in 2005, up from a projected $100 billion in 2004, the agency says.

Among other provisions, the rule

  • provides an update for those hospitals that report on quality
  • reduces the impact of labor rates on the wage index for hospitals with relatively low labor costs, increasing the payment rates for most rural hospitals
  • provides additional payments for hospitals in remote areas to reflect the higher costs associated with having a low volume of total discharges
  • increases payments for new medical technologies

    Resources:

    The final rule will be published in the August 11 Federal Register. It takes effect for hospital discharges on or after October 1, 2004.

    To read CMS' press release, click here.

    To read CMS' fact sheet, click here.



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