Health Information Management

News: Behavioral offset for inpatient claims reduced under new legislation

CDI Strategies, October 18, 2007

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President Bush recently signed legislation to reduce the "behavioral offset," or Inpatient Prospective Payment System payment cut, that CMS had planned to implement starting in fiscal year 2008. CMS had planned to reduce IPPS payment by 1.2% in 2008, and 1.8% in both 2009 and 2010, in order to "offset" the improved documentation and coding it had anticipated hospitals to make. These anticipated improvements are due in large part to the efforts of clinical documentation improvement specialists.

Under the new legislation, CMS will cut IPPS payment by half that anticipated amount--0.6% in 2008, and 0.9% in 2009. The 2010 cut of 1.8% will be left intact, however.

The "TMA, Abstinence Education, and QI Programs Extension Act of 2007" (H 3668) is expected to restore an estimated $2.5 billion in IPPS payment over the next two years. You can read the Act here.



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