The Centers for Medicare & Medicaid Services recently proposed a rule for fiscal year 2004 that includes a 3.5% increase in payment rates beginning October 1, 2003, to hospitals for inpatient services furnished to individuals with Medicare coverage. Under the proposed rule, the outlier threshold would increase to $50, 645.00 up from $33,560.00 in 2003, in order to limit outlier payments to 5.1% of total payments under the inpatient PPS. In a separate rulemaking procedure, CMS is planning to revise the rules governing outlier payments.
The proposed rule would expand the post-acute transfer policy, which now applies to 10DRGs, to an additional 19DRGs. This policy treats discharges involving the designated DRG’s from an acute care hospital to a post-acute setting as a transfer. As a result, the transferring hospital is paid a per diem rate, not exceed the full payment for the DRG. It will also discuss the potential for excluding wage data from critical access hospitals in calculating the hospital wage index and specifically invites public input on this idea.
Comments from the public will be accepted until July 8, 2003. The proposed rule was published in the Federal Register, May 19th, 2003.
For more information on this topic please visit the CMS Web site at, http://www.cms.gov/media/press/release.asp?Counter=733 .