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The Centers for Medicare & Medicaid Services (CMS) has released its proposed rule for inpatient Medicare payments for fiscal year 2004.

Critical Path Network: CMS releases proposed rule on inpatient payments

July 1, 2003

Critical Path Network: CMS releases proposed rule on inpatient payments

The Centers for Medicare & Medicaid Services (CMS) has released its proposed rule for inpatient Medicare payments for fiscal year 2004.

Among the key items in the nearly 1,000-page rule are the following.

  • CMS has calculated the market basket’s increase in the cost of care to be 3.5% for FY 2004. However, due to budget neutrality and other adjustments, average payments to hospitals will rise only by 2.5%.
  • The rule expands the post-acute care transfer policy to an additional 19 diagnosis-related groups. In an article by the on-line news service AHA News Now, the American Hospital Association states that the estimated loss to hospitals would be $160 million in FY 2004.
  • The rule raises the outlier threshold for extremely high-cost cases to $50,645 from $33,560. AHA said it expects a separate outlier rule soon from CMS that will contain adjustments expected to reduce that threshold.

To see the rule, go to: http://cms.hhs.gov.