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How will CMS’ proposed rule for 2019 impact hospitals?

The Centers for Medicare and Medicaid Services (CMS) recently filed its 2019 Medicare Inpatient Prospective Payment System (IPPS) proposed rule.

What is the IIPS? The IIPS is a system used by the government for payment of care provided by acute care hospitals. The government updates the rules used to govern this system on an annual basis.

How is the system updated? Generally, the CMS will provide a proposed rule followed by a comment period. During this time, the government allows medical professionals, hospital administrators and others to voice any concerns that may be present if the proposal is implemented as written. After the comment period closes, the government implements the final rule.

Why are these rules important? A failure to properly follow the rules for payment can result in allegations of Medicare fraud.

How will the new rule impact hospitals? The rule will impact medical professionals and hospitals in various ways. Three specific impacts to hospitals included:

  • Paperwork requirements eased. The rule reduces the amount of paperwork hospitals must complete in order to receive payment from government agencies. The CMS estimates this change will save over 2 million hours in time previously used used to meet these requirements.
  • Transparent prices required. Current law requires hospitals make the cost of care available to the public or to provide it if asked. This proposal would increase the hospital’s burden to provide this information by requiring hospitals to provide a list of charges for various procedures online.
  • CMS will pay more to acute care hospitals. The CMS has stated it will increase the payment for acute care hospitals by 1.75 percent.

The proposal was filed in April and is scheduled to go into effect October 1, 2018.

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