Inpatient pay rule would give hospitals $2.5 billion boost
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CMS on Tuesday proposed eliminating its plan for providers to disclose their contract terms with Medicare Advantage insurers, one of a slew of high ticket changes in its Hospital Inpatient Prospective Payment System rule.
In the proposed rule, CMS said hospitals would no longer be expected to report the median payer-specific negotiated charge with MA insurers on its Medicare cost reports retroactive to Jan. 1, 2021. The change would eliminate more than 63,000 burden hours for providers.
Hospitals have long challenged the agency s attempts to impose price transparency requirements, maintaining they wouldn t help consumers or lower healthcare costs.
CMS’s new rule proposal increases payment rates, focuses on health equity and workforce
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The rule touches on a wide range of issues which are detailed below.
Payment rates & transparency requirements:
The rule proposes increasing operating payment rates for acute care hospitals paid under the Hospital Inpatient Prospective Payment System (IPPS) by 2.8%.
“This reflects the projected hospital market basket update of 2.5 percent reduced by a 0.2 percentage point productivity adjustment and increased by a 0.5 percentage point adjustment required by legislation.”
The rules stipulates that the 2.8% rate increase is for hospitals that participate in the Hospital Inpatient Quality Reporting Program and are “meaningful electronic health record users.”
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The Centers for Medicare and Medicaid Services has updated the Medicare fee-for-service payment rates and policies for inpatient hospitals and long-term care hospitals for 2022.
Before taking into account Medicare disproportionate share hospital payments and Medicare uncompensated care payments, the proposed increase in operating payment rates, increases in capital payments, increases in payments for new medical technologies, increases in payments due to implementation of the imputed floor and other proposed changes will increase hospital payments in FY 2022 by $3.4 billion, or 2.8%.
But there is much in the proposed rule beyond payment updates.
The proposed rule would require hospitals to report vaccination rates among healthcare staff. CMS is proposing the adoption of the COVID-19 Vaccination Coverage among Healthcare Personnel Measure to require hospitals to report COVID-19 vaccinations of workers in their facilities.