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

Final FY 2021 Medicare IPPS and LTCH PPS Update Released

 The Centers for Medicare and Medicaid Services (CMS) have released a final 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 acknowledges this rule is late. It is normally due about August 1, but because of the COVID-19 pandemic CMS is waiving the normal 60-day publication date before implementation this year to 28 days. The rule will still be effective October 1, 2020. 
CMS is finalizing numerous items including the following; (a) Market-Based MS-DRG Relative Weight Data Collection and Change in Methodology for Calculating MS-DRG Relative Weights (the reporting of negotiated rates); (b) MS-DRG Documentation and Coding Adjustment; (c) Changes to the New Technology Add-On Payment Policy; (d) Continuation of the Low Wage Index Hospital Policy; (e) DSH Payment Adjustment and Additional Payment for Uncompensated Care; (f) Reduction of Hospital Payments for Excess Readmissions; (g) Hospital Value-Based Purchasing (VBP) Program; (h) Hospital Inpatient Quality Reporting (IQR) Program; (i) Hospital-Acquired Condition (HAC) Reduction Program; (j) PPS-exempt Cancer Hospital Quality Reporting Program; and (k) Medicare and Medicaid Promoting Interoperability Programs. 
The 2,160-page document is currently on public display at the Federal Register office and is scheduled for publication September 18. A display version is available at: https://s3.amazonaws.com/public-inspection.federalregister.gov/2020-19637.pdf

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

The LTCH PPS tables are also available on the CMS website at: http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/LongTermCareHospitalPPS/index.html under the list item for Regulation Number CMS-1735-F.

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