CMS releases FY 2014 IPPS final rule   08/02/2013
The Centers for Medicare & Medicaid Services today released the fiscal year 2014 hospital inpatient prospective payment system final rule. Under the rule, inpatient PPS rates will increase by 0.7% in FY 2014 compared to FY 2013, after accounting for inflation and other adjustments required by law. Specifically, the rule includes an initial market basket update of 2.5% for those hospitals that submit data on quality measures; hospitals not submitting data will receive a 0.5% update. The rule makes a productivity cut of 0.5 percentage points and a 0.3 percentage point cut mandated by the Patient Protection and Affordable Care Act. In addition, CMS will make a 0.8 percentage point cut that would, in part, fulfill the requirement of the American Taxpayer Relief Act that it recoup what the agency claims is the effect of documentation and coding changes from FYs 2010, 2011 and 2012 that CMS says do not reflect real changes in case-mix. The agency also will make a 0.2 percentage point cut to offset the effect of its inpatient admission and medical review criteria for hospital inpatient services. CMS finalized its proposal to generally consider hospital inpatient admissions spanning two midnights as reasonable and necessary for payment under Part A. “While hospitals have wanted clarification of inpatient admission criteria, this final rule is unlikely to reduce the number of appeals of Part A claim denials, which CMS said was one of the primary goals of its rulemaking,” said (LINK) AHA Senior Vice President Linda E. Fishman. The rule also implements the ACA-mandated Medicare Disproportionate Share Hospital reductions, which will reduce overall Medicare DSH spending by about $550 million in FY 2014, as opposed to the proposed $1 billion cut. As proposed, CMS will use inpatient days of Medicaid beneficiaries plus inpatient days of Medicare supplemental security income beneficiaries as a proxy for measuring the amount of uncompensated care each hospital provides. AHA members will receive a Special Bulletin with further details Monday.
CMS finalizes rebilling policy   08/02/2013
The Centers for Medicare & Medicaid Services today finalized its policy on rebilling Part A claims denied by Medicare contractors, including recovery audit contractors, as part of its fiscal year 2014 hospital inpatient prospective payment system final rule. CMS generally limited rebilling, as proposed, to those claims that are within one year of the date the service were provided. In a statement, AHA said the policy “demonstrates that CMS is unwilling to fundamentally change its rebilling policy. While they have extended the deadline for very few additional claims, such change will have little practical effect overall. We intend to proceed with our lawsuit.” AHA members will receive a Special Bulletin with further details Monday.
CMS releases FY 2014 LTCH final rule   08/02/2013
The Centers for Medicare & Medicaid Services today released the fiscal year 2014 long-term care hospital prospective payment system final rule, which will increase overall payments by 1.3% in FY 2014, compared to FY 2013. As noted in the proposed rule, CMS will begin to phase in the full “25% Rule” policy starting with cost reporting periods beginning on or after Oct. 1. In a statement, said this policy “imposes a barrier by reducing payments based on the origin of the referral, with no regard for a patient’s medical necessity for these services.” The agency also will continue with plans to implement a proposal in FY 2015 that dramatically reduces LTCH payments by excluding patients who do receive a qualifying amount of intensive care unit use in a prior hospital stay. AHA staff is reviewing the rule and members will receive a Special Bulletin Monday with further details.
House committee issues draft post-acute care legislation   08/02/2013
The House Ways and Means Committee today released for public comment draft legislation to reduce Medicare reimbursement for post-acute care providers, based on proposals included in the president’s fiscal year 2014 budget as well as discussions by the Simpson-Bowles Commission and Bipartisan Policy Center. Specifically, the draft legislation would reduce market basket updates for home health agencies, skilled nursing facilities, inpatient rehabilitation facilities and long-term care hospitals; create site-neutral payments between IRFs and SNFs for certain procedures; modify the criteria required for IRF status (or 75% Rule); establish a SNF readmissions program; and create PAC bundled payments. In a statement submitted to the committee in June, AHA said it supports efforts to bring meaningful reform to the post-acute care field, but that many of the proposals highlighted in the president’s FY 2014 budget proposal include arbitrary cuts that would threaten patients’ access to post-acute care services. Comments on the draft legislation should be emailed by Aug. 30 to entitlementreform@mail.house.gov.
IOM issues plan for evaluating obesity prevention efforts   08/02/2013
The Institute of Medicine today released a framework for evaluating obesity prevention strategies recommended in the 2012 IOM report “Accelerating Progress in Obesity Prevention.” The framework includes separate but interdependent plans for evaluating the strategies at the national and community levels, and identifies 83 indicators that evaluators could use to measure progress in obesity prevention. The committee recommends creating a task force or other entity to oversee and lead the national plan and provide support to the community plan. Among other actions, the committee said federal agencies and state and local health departments should work with other pertinent organizations to improve and standardize data collection and analysis, including data on disparities and populations at elevated risk for obesity, and improve workforce capacity for evaluation.
CDC: Breastfeeding rates, support continue to rise   08/02/2013
Seventy-seven percent of U.S. babies started breastfeeding in 2010, up from 70% in 2000, according to the latest annual report from the Centers for Disease Control and Prevention. About half of babies were breastfeeding at six months and 27% at 12 months in 2010, up from 35% and 16%, respectively, in 2000. “This is great news for the health of our nation because babies who are breastfed have lower risks of ear and gastrointestinal infections, diabetes and obesity, and mothers who breastfeed have lower risks of breast and ovarian cancers,” said CDC Director Tom Frieden, M.D. Also on the rise are the proportion of hospitals and birth centers meeting certain “breastfeeding support” indicators for mothers and babies, such as skin-to-skin contact after birth (54%) and rooming together (37%), CDC said. The report includes national and state-level data.
Report, tool show projected impact of full ACA implementation on communities   08/02/2013
A report released this week by the Kaiser Family Foundation provides highlights from new state and sub-state estimates of how the number and composition of individuals enrolled in Medicaid and the Children’s Health Insurance Program would change with full implementation of the Patient Protection and Affordable Care Act, including the Medicaid expansion. The foundation also released an interactive map that shows how Medicaid enrollment and the uninsured population could change in specific communities if a state expands Medicaid.
Hospital jobs decline by 4,400 in July   08/02/2013
Employment at the nation's hospitals fell by 0.09% in July to a seasonally adjusted 4,825,100 people, the Bureau of Labor Statistics reported today. That's 4,400 fewer people than in June and 36,400 more than a year ago. Without the seasonal adjustment, which removes the effect of fluctuations due to seasonal events, hospitals employed 4,835,100 people in July - 3,700 more than in June and 33,200 more than a year ago. The nation's overall unemployment rate fell by 0.2 percentage point in July to 7.4%.