2019 FINAL RULES IPPS

An Analysis and Commentary on Federal Health Care Issues by Larry Goldberg

Massive Final FY 2020 Medicare IPPS and LTCH Update Released

The Centers for Medicare and Medicaid Services (CMS) have released an extensively long final rule to update both the Hospital Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System for fiscal year (FY) 2020.

Some of the many items discussed include the following; (1) the hospital market basket increase; (2) MS-DRG documentation and coding; (3) revisions to the calculation of the area wage index; (4) new technology add-on payments; (5) Medicare uncompensated care payments; (6) hospital-acquired conditions; (7) the hospital readmission program; (8) the hospital inpatient quality reporting system (9) the hospital valuebased purchasing program; (10) the Medicare and Medicaid promoting interoperability programs; and (11) changes to the LTCH system.

The 2,273-page document is currently on public display at the Federal Register office and is scheduled for publication August 16. A display version is available at: https://s3.amazonaws.com/public-inspection.federalregister.gov/2019-16762.pdf.

The IPPS tables are available on the CMS website at: https://www.cms.gov/Medicare/Medicare-Fee-for- Service-Payment/AcuteInpatientPPS/index.html. Click on the link on the left side of the screen titled, “FY 2020 IPPS Final Rule Home Page” or “Acute Inpatient—Files for Download.”

The LTCH PPS tables are at: http://www.cms.gov/Medicare/Medicare-Fee-for-Service- Payment/LongTermCareHospitalPPS/index.html under the list item for Regulation Number CMS-1716-F.

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