Revenue Cycle

CMS to increase payments to hospitals reclassified under MMA

Patient Financial Services Weekly Advisor, April 23, 2004

CMS announced April 20 that 121 hospitals in 25 states will begin receiving higher payments for patients who are discharged on or after April 1.

According to CMS, the increases are due to the geographic reclassification of these hospitals under a special, one-time-only provision in the Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA). The new payments will be retroactive to April 1.

As part of MMA, Congress directed CMS to create a one-time-only appeals procedure for certain hospitals that fell just outside Medicare's existing criteria for reclassification from their current geographic areas into an adjoining area with higher payment rates, but were deemed to be in need of financial relief, the release said.

The decisions on the individual cases were made by the Medicare Geographic Classification Review Board, an independent panel within CMS that is responsible for handling geographic-classification appeals under the general criteria in the regulations.

To read the CMS release, click here.

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