August 8, 2019
This special edition of MHA Today is provided as a service to members of the Missouri Hospital Association. Additional information is available online at MHAnet.
Staff Contact: Andrew Wheeler
MHA has published an issue brief on the fiscal year 2020 Medicare acute inpatient and long-term care hospital prospective payment system payment and policy updates. The rule includes a Medicare inpatient payment increase of 3 percent or $3.8 billion, and a long-term care hospital increase of 1 percent or $43 million.
The rule includes a significant change in the wage index system. Through the Centers for Medicare & Medicaid Services’ “Rethinking Rural Health” initiative, the rule increases the wage index for hospitals in the lower 25th percentile. However, the final rule addresses some of the controversy generated in proposed rulemaking by modifying the budget neutrality portion of the program, which would have reduced high-index states’ payments to increase low-index states. The rule also addresses the “rural floor” section that had warped the national calculation to the benefit of a handful of states.
The rule includes final determination on a variety of other issues, including distributing Medicare disproportionate share uncompensated care payments based on FY 2015 cost report S-10 data; changes to programs and payments within the quality and value domain; publishing the Case-mix group revisions; clarifying the determination of whether a physician qualifies as a rehabilitation physician; and technology add-on payments.
The full text of the rule is available in the Federal Register. The federal fiscal year begins Oct. 1.