FFY 2025 IPPS Proposed Rule
Toyon's summary of the FY25 IPPS Proposed Rule, focused on areas directly impacting Medicare cost reporting and provider reimbursement, followed by an analysis and observations of the Proposed Rule.
FFY 2024 IPPS Final Rule
Toyon's summary of the FY24 IPPS Final Rule, focused on areas directly impacting Medicare cost reporting and provider reimbursement for acute care hospitals.
FFY 2024 IPPS Final Rule: National Medicare IPPS Estimates
CMS estimates IPPS hospitals will receive an increase of $2.2 billion compared to FFY 2023.
FFY 2024 IPPS Final Rule: Standardized Base Rates and DRG Weights
CMS adjusted FFY 2024 rates based on FFY 2022 MEDPAR claims and FFY 2021 HCRIS data, while also implementing payment reductions for hospitals not meeting Hospital Inpatient Quality Reporting (IQR) or Promoting Interoperability of Electronic Health Record (EHR) requirements, with decreases in MS-DRG relative weights capped at a maximum reduction of ten percent from FFY 2023 weights.
FFY 2024 IPPS Final Rule: Uncompensated Care (UC) DSH
CMS finalized a decrease in Medicare UC DSH payments by -$950 million, to $6.0 billion in FFY 2024. In FFY 2024, providers will receive a UC DSH payment representing 17.5% of UC Costs, whereby in FFY 2023 providers received 20.2% of UC Costs. CMS is also now using a three-year average of UC cost to determine each DSH hospital’s portion of the fund.
FFY 2024 IPPS Final Rule: Empirical DSH
Discussion of finalized changes to regulations on the inclusion of certain Section 1115 demonstration days in the Medicaid fraction of the empirical DSH calculation, and the impact on reporting of patient days for patients discharged on or after October 1, 2023 (FFY 2024).
FFY 2024 IPPS Final Rule: Wage Index
Discussion of CMS updates to wage index calculation and implementation of a “transition” policy.
FFY 2024 IPPS Final Rule: Graduate Medical Education (GME) and Nursing/Allied Health
CMS finalized the Nursing and Allied Health MA add-on rates and direct GMA MA percent reductions for CY 2022, and finalized that effective for cost reporting periods beginning on or after October 1, 2023, REHs may be considered a non-provider site.
FFY 2024 IPPS Final Rule: Low-Volume Adjustment
CMS extends the alternative requirements to September 30, 2024, for certain hospitals to qualify for the low-volume adjustment.
FFY 2024 IPPS Final Rule: Medicare Dependent Hospital (MDH) Status
Section 4102 of the 2023 CAA extends the MDH program through FFY 2024. CMS notes “generally...a provider that was classified as an MDH as of December 23, 2022, was reinstated as a MDH effective December 24, 2022, with no need to reapply for MDH classification.”
FFY 2024 IPPS Final Rule: Value-Based Purchasing (VBP) Incentives
CMS re-implements the VPB program in FFY 2024 whereby providers are subject to a 2 percent reduction in payments to contribute to the VBP payment pool.
FFY 2024 IPPS Final Rule: Hospital-Acquired Conditions (HAC) Penalty
CMS re-implements the HAC penalty (1 percent) for those hospitals in the lowest quartile on select measures of hospital-acquired conditions.
FFY 2024 IPPS Final Rule: Request for Information on Safety Net Hospitals
CMS cited recent MedPAC recommendations to Congress to establish a hospital Medicare Safety-Net Index (MSNI) that measures Medicare Low-Income Subsidy Enrollment Ratio, Ratio of Uncompensated Care Costs to Total Operating Revenue, and Medicare share of Total Inpatient Days.
T-18 Changes: Other Notable Changes and Clarifications
What else you need to know from CMS’s new cost reporting instructions for 2022 onwards.
