Final Rules for Hospital Inpatient Prospective Payment Systems

The Centers for Medicare & Medicaid Services released the final rule for the Medicare inpatient prospective payment systems (IPPS) for the 2013 fiscal year (effective for discharges occurring on or after October 1, 2012).  The final rule revises the IPPS for operating and capital-related costs of acute care hospitals and incorporates certain statutory provisions contained in the 2010 Patient Protection and Affordable Care Act, as amended in part by the  Health Care and Education Reconciliation Act of 2010.

Additionally, the final rule updates the rate-of-increase limits for certain hospitals excluded from the IPPS, as well as the payment policies and annual payment rates for the Medicare prospective payment system (PPS) relating to long-term care hospitals. The final rule changes the ways in which a hospital determines its full-time equivalent (FTE) resident cap for graduate medical education (GME) and indirect medical education (IME) payments.

The final rule also establishes requirements for the Hospital Value-Based Purchasing (VBP) Program and the Hospital Readmissions Reduction Program.

The entire final rule, which will be codified in 42 CFR Parts 412, 413, 424 and 476 can be seen here.