• CMS Issues Proposed Rules for Hospice and IPPS
  • May 8, 2014 | Authors: Leslie J. Levinson; Michaela ("Kayla") Tabela
  • Law Firms: Edwards Wildman Palmer LLP - New York Office ; Edwards Wildman Palmer LLP - Boston Office
  • On May 2, 2014, the Centers for Medicare & Medicaid Services (“CMS”) issued a proposed rule to update the Medicare hospice payment rates and the Medicare wage index for fiscal year (“FY”) 2015. CMS estimates that under this proposed rule hospice providers would see an estimated 1.3 percent increase (approximately $230 million) in their payments for FY2015. The rule also proposes requirements related to the self-reporting of payment caps and updates for the hospice quality reporting programs, and solicits comments on the definitions of “terminal illness” and “related conditions.” The proposed rule will be published in the May 8, 2014 Federal Register.

    On April 30, 2014, CMS issued the inpatient prospective payment system (“IPPS”) proposed rule for FY2015. The IPPS proposed rule would implement several statutory provisions contained in the Affordable Care Act, including policies relating to the Hospital Value-based purchasing program, the Hospital Readmissions Reduction Program, and the Hospital-Acquired Condition (“HAC”) Program. Other key changes from the proposed rule include:

    • a 1.3 percent increase in IPPS operating payment rates;
    • penalties for hospitals that do not participate in the Hospital Inpatient Quality Reporting Program and fail to submit the required data or that are not meaningful electronic health record users;
    • adjustments to the methodology for Medicare disproportionate share hospital (“DSH”) payments; and
    • changes to the wage index for acute care hospitals based on the 2010 Census and hospital reclassifications and redesignations by the Office of Management and Budget (“OMB”).

    The rule also asks stakeholders to provide comments on, among other things, an alternative payment approaches for short hospital stays.

    The IPPS proposed rule will be published in the May 15, 2014 Federal Register.