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New IPPS Proposed Rule Released

DATE: 05/03/2018

Comments due to CMS by June 25

The Centers for Medicare and Medicaid Services (CMS) released its FFY 2019 Inpatient Prospective Payment System (IPPS) proposed payment rule. While we’re working on our in-depth analysis, a few key points and issues have already emerged in our review.

The proposed rule reflects the annual updates to the Medicare fee-for-service (FFS) inpatient payment rates and policies. While it includes the types of updates to wage indexes and marketbasket we typically see, this rule also includes:

  • a 1.5% increase to the proposed operating payment rate;
  • updates to Medicare Disproportionate Share Hospital (DSH) payment policies, including the continued phase-in of worksheet S-10;
  • continuance of the Medicare Dependent Hospital and expanded Low-Volume Hospital programs;
  • the addition of hospice transfers to the Post-Acute Care Transfer Policy;
  • the elimination of 19 measures and de-duplication of 21 measures across CMS’ quality programs;
  • updates to the payment penalties for non-compliance with the Hospital Inpatient Quality Reporting (IQR) and Electronic Health Record Incentive programs; and
  • the opportunity to obtain additional residency slots.

CMS requested comments on the regulatory and policy changes to the Medicare wage index that address area wage index disparities. CMS has also requested information on the sharing of healthcare data between providers, and separately on how price transparency can be improved. Those comments, as well as any additional comments, are due to CMS by June 25.

DataGen is estimating the impact on what this rule would mean for hospitals around the country.

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