The Centers for Medicare & Medicaid Services (CMS) has issued the final rule establishing fiscal year (FY) 2012 policies and payment rates for inpatient services furnished to Medicare beneficiaries by acute care hospitals, long term care hospitals (LTCH) and certain excluded hospitals. CMS projects that total Medicare operating payments to acute care hospitals for inpatient services occurring in FY 2012 will increase by $1.13 billion, or 1.1% because of a 1.0 percent increase in payment rates together with other policies adopted in the final rule. Medicare payments to LTCHs are projected to increase by $126 million or 2.5 percent.
The final rule also strengthens the Hospital Inpatient Quality Reporting (IQR) Program by placing greater emphasis on preventing health care-associated infections in general acute care hospitals and establishes the framework for a new quality reporting programs that will apply to hospitals paid under the LTCH PPS.
In addition, CMS is required by provisions in the Affordable Care Act (ACA) to implement the Hospital Readmissions Reduction Program beginning October 1, 2012. Through this program, CMS will reduce payment to those hospitals that have excessive readmissions for three conditions – acute myocardial infarction, heart failure, and pneumonia. The rule also establishes the methodology that will be used to calculate excessive readmission rates for these conditions.
The final rule also lays the groundwork for a quality reporting program under the LTCH PPS by establishing the first measure set for reporting beginning October 1, 2012.
The final rule can be found by going to http://www.ofr.gov/OFRUpload/OFRData/2011-19719_PI.pdf