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Meaningful Health Care Informatics Blog

Aug 6 2012   9:35PM GMT

CMS ISSUES FINAL INPATIENT PAYMENT RULE FY 2013



Posted by: RedaChouffani
CMS

The Centers for Medicare & Medicaid Services (CMS) today issued a final rule that updates fiscal year (FY) 2013.  Under this rule the payment rates for acute care hospitals will be increased by 2.8 percent in 2013.

Hospitals are at the forefront of our strategy to both save money and improve the quality and coordination of care,” said CMS Acting Administrator Marilyn Tavenner. “This rule takes further important steps to ensure all patients receive the best possible care.”

As part of pushing for improved care, there are provisions that are meant to encourage the reduction of hospital readmissions post the following conditions: (heart attack, heart failure and pneumonia).  The provisions will reduce payments beginning in FY 2013.  For Hospital value-based purchasing program, the rule rewards for efficient and high quality care by adjusting the hospital payment based on the performance against a set of quality measures.

CMS has also finalized additional items regarding the SCHIP Extension Act Moratorium.

  • An extension of the existing moratorium on the “25 percent threshold” policy as well as a providing a supplemental moratorium for certain LTCHs and LTCH satellite facilities, pending results of an on-going research initiative to re-define the role of LTCHs in the Medicare program.
  • A 1.3 percent reduction (first year of a three-year phase-in) for a permanent prospective budget neutrality adjustment.  The reduction would not apply to discharges occurring on or before December 28, 2012, because the law prohibits its application before that date.  The budget neutrality adjustment reduces the update from 1.8 percent to 0.5 percent.

The document is currently available for review and public comment here

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