Hospital Associations Object To Proposed Medicare Rule They Say Would Reduce Scheduled Payment Increase

More changing of the payment codes and the numbers...BD

Hospital associations are "in a state of outrage" over a Medicare rule proposed by CMS that they say would reduce a scheduled increase in hospital reimbursements by assuming hospitals will "game the new system," the Philadelphia Inquirer reports. The rule -- which is under a comment period until June 12 and would go into effect in October if approved -- would increase the number of diagnosis-related groups from 538 to 745 to more accurately classify hospital care and provide higher reimbursements for treating sicker patients. Medicare reimbursements for hospitals are scheduled to increase an average of 3.3%, or $3.28 billion, this year in accordance with the market-basket rate. However, the CMS rule includes a "behavioral offset" of 2.4%, which the agency says is necessary to compensate for anticipated higher average patient severity scores that will result from the updated DRG system.

American Hospital Association Vice President for Policy Don May said the offset was "back-door budget slashing" and would cost hospitals $2.4 billion.

Source:  Hospital Associations Object To Proposed Medicare Rule They Say Would Reduce Scheduled Payment Increase