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CMS Seeks to Boost Medicare Reimbursement for Inpatients

Earlier this week, the Centers for Medicare & Medicaid Services (CMS) proposed a new rule updating the Inpatient Prospective Payment System (IPPS). Beginning in October, CMS is proposing an update of three percent hospital market basket less a productivity adjustment of 0.4 percentage point. The new Medicare inpatient reimbursement rates will also represent a planned change of 0.5 percentage point mandated by legislation.

Along with these changes, the rule would also allocate nearly $7.8 billion in uncompensated care compensation, down $0.5 billion during the 2021 fiscal year. Furthermore, a new technology add-on payment mechanism will be developed for certain antimicrobial products.

Collectively, the CMS changes being proposed in unpaid care payments, new technology add-on payments and capital payments will reduce inpatient Medicare reimbursement rates by 0.4 percent, resulting in a total rise of approximately 1.6 percent in overall rates under the IPPS. These changes, which would affect more than 3,000 acute care hospitals and close to 300+ long-term care hospitals, would impact discharges occurring on or after October 1, 2020, according to CMS.

If you’re interested, the entire CMS rule proposal can be viewed at the following link: https://www.federalregister.gov/documents/2020/05/29/2020-10122/medicare-programs-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the. For more information about the rule, please visit the source article: https://revcycleintelligence.com/news/cms-proposes-to-increase-inpatient-medicare-reimbursement-by-1.6.

This update is provided by CareOptimize. We provide healthcare management consulting services and products and we’ve helped numerous healthcare organizations succeed for more than a decade. We provide managed care solutions as well as products like coding modules, next-generation EHR utilities, MIPS consulting, and more. For more information, please call 855.937.8475.