The CMS has reversed course on its plans to lower payments for acute-care hospitals, giving them instead a 2.1% increase in their reimbursement rates rather than a 1.9% reduction for fiscal 2010.
In a proposed rule released earlier this year, the CMS said it would take into account so-called “upcoding” that is likely to occur as hospitals transitioned from one coding system to a newer one, known as the Medicare severity diagnosis-related groups, or MS-DRGs.
The CMS, however, said it has not completed a full study to examine what effect the move to the new coding system has had on billing offices in the nation's 3,500 acute-care facilities. If needed, the CMS said it would consider phasing in future adjustments beginning in fiscal 2011.
Additionally, the CMS said that teaching hospitals would continue to receive the full capital indirect medical education adjustment. In fiscal 2008, the CMS planned to reduce such payments by 50%—a move overturned by Congress.
In its most recent rule, however, the agency said it looked at updated studies of hospital margins and took into account industry comments before it decided “not to go forward with full phase-out as previously planned next year.”
As planned, the CMS said it plans to expand the number of quality measures hospitals need to report on by four, adding two measures to the existing Surgical Care Improvement Project, while the other two would impact nursing care and care for stroke patients.
Hospitals that don't successfully report on measures in fiscal 2010 won't be eligible for a full inflationary update next year.
Separately, under the final rule released on Friday, long-term-care hospitals will receive an update of 2.5% even though the CMS plans to cut payment rates by half a percentage point in rate year 2010.
“The policies and payment rates in this final rule will ensure that Medicare beneficiaries continue to have access to high quality inpatient care in both short-stay acute-care and long-term-care hospitals,” Jonathan Blum, director of the CMS Center for Medicare Management, said in a written statement.
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