CMS Issues Final Rules Boosting Payments for Inpatient, Hospice Care
On Monday, CMS released two final rules managing the Medicare payment schedule for hospice care and general acute care and long-term care hospitals for fiscal year 2015, Modern Healthcare reports.
Hospice Payment Rule
CMS in its first rule increased payments for hospices in fiscal year 2015 by 1.4%, or $230 million, more than FY 2014 payments.
The rule also finalized a requirement that hospices submit a "notice of election" within five days of a patient referral or face fines. According to Modern Healthcare, the rule is designed to reduce non-hospice claims that are related to a patient's terminal condition.
However, CMS said that providers can appeal a missed deadline for the requirement because of exceptional circumstances, such as damages from a fire, flood or earthquake (Dickson/Demko, Modern Healthcare, 8/4).
Inpatient Payment Rule
The rule is scheduled to take effect Oct. 1 (Modern Healthcare, 8/4). It affects 3,400 acute care hospitals and about 435 long-term care hospitals (Goad, The Hill, 8/4).
CMS also announced that it would distribute $7.65 billion in payments to hospitals for uncompensated care, a drop from the initially proposed $8.56 billion. The agency said that the decrease in such payments for Medicare Disproportionate Share Hospitals was linked to lowered estimates on hospital inpatient spending, as well as revised estimates for the number of uninsured patients.
In addition, CMS announced a market basket update of 2.9%, although it said that the rate would decrease by one-quarter among hospitals that do not adequately participate in CMS' quality reporting or electronic health record programs (Reuters, 8/4).
The rule also increases the maximum payment reduction from 2% to 3% under the Hospital Readmissions Reduction Program, which aims to reduce payment for hospital-acquired conditions and readmissions. Acute care hospitals that report the most hospital-acquired conditions will see Medicare reimbursement reductions of 1% (Modern Healthcare, 8/4).
Overall, CMS projected that payments to acute care hospitals would decrease by $756 million and that payment to long-term care hospitals would increase by $62 million (Reuters, 8/4).
American Hospital Association Senior Vice President Linda Fishman said that the cuts included in the inpatient care rule "will make it more difficult for hospitals to maintain their commitment to their communities." She added, "These payments provide vital support to hospitals that serve the most vulnerable patients" (Reuters, 8/4).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.