2021 PROPOSED RULES IPPS

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

Proposed FY 2021 Medicare IPPS and LTCH PPS Update Released

The Centers for Medicare and Medicaid Services (CMS) have released another extensively long proposed 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) 2021.

CMS is proposing numerous items including the following; (1) changes to the MS–DRG classifications and recalibrations of relative weights; (2) status of FY 2021 new technology applicants under the alternative pathways for certain medical devices and certain antimicrobial products; (3) changes to the hospital wage index; (4) changes to payment for allogeneic hematopoietic stem cell acquisition costs; (5) payment adjustment for chimeric antigen receptor (CAR) T-cell therapy clinical trial cases; (6) requirements for payment adjustments under the Hospital Readmissions Reduction Program; (7) newly established performance standards for the calculation of value-based incentive payments under the Hospital Value-Based Purchasing Program; (8) payment adjustments to hospitals under the Hospital Acquired Reduction (HAC) program; (9) policy changes related to medical residents affected by residency program or teaching hospital closure; and, (10) changes relating to quality data reporting

The 1,602-page document is currently on public display at the Federal Register office and is scheduled for publication May 29. A display version is available at: https://s3.amazonaws.com/publicinspection.federalregister.gov/2020-10122.pdf. A comment period ending July 10 is provided.

The IPPS tables for the FY 2021 proposed rule are available through the Internet on the CMS website at: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/index . Click on the link on the left side of the screen titled, “FY 2021 IPPS Proposed Rule Home Page” or “Acute Inpatient—Files for Download.”

The LTCH PPS tables for this FY 2021 proposed rule are available through the Internet on the CMS website at: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/LongTermCareHospitalPPS/index under the list item for Regulation Number CMS-1735-P.

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