CMS-1420-F (Publication Date: August 6, 2009): The Centers for Medicare & Medicaid Services (CMS) issued a final rule to update the Medicare Hospice Wage Index for fiscal year (FY) 2010. This rule revises the phase-out of the hospice wage index budget neutrality adjustment factor (BNAF), which was finalized in the FY 2009 final rule, to now occur over 7 years. As a result of this final rule, the BNAF will be reduced by 10 percent in FY 2010, and 15 percent each year from FY 2011 through FY 2016. The combined effects of a 10% reduction to the BNAF in the FY 2010 Hospice Wage Index and a 2.1% hospital market basket update are estimated to increase payment to hospices in FY 2010 by 1.4 percent. In addition, this final requires hospice physicians to provide a short narrative as part of hospice certifications and recertifications of terminal illness.
Hospice Wage Index – FFY 2010
February 25, 2010
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IME Payments
February 23, 2010INDIRECT MEDICAL EDUCATION (IME) – payments for extra costs of additional diagnostics, etc. by using residents and interns in a teaching hospital, who are less experienced than doctors. A CMS summary of this can be found here.
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GME Payments
February 21, 2010GRADUATE MEDICAL EDUCATION (GME) – payments for training residents and interns in a teaching hospital. A CMS summary of this can be found here.
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DSH Bonus
February 19, 2010DSH – Hospitals serving a large population of indigent patients may receive a DSH bonus to their Medicare payments. This is summarized by CMS in the following summary.
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Hospital Outliers
February 17, 2010Hospitals can receive bonus payments above the DRG payment for the following reasons:
OUTLIERS – payments for very expensive cases. A CMS summary of this can be found here.
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Hospice Caps
February 15, 2010There is a cap on Medicare reimbursement for inpatient hospice care days, and also a cap for an average payment per beneficiary. . Palmetto’s website has a nice summary of these caps and a calculator to calculate overpayments due to these caps. It can be found here.
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Medicare GME and IME Credit
December 9, 2009To get credit for Medicare GME and IME for Medicare HMO days, the hospital must send no-pay bills to Medicare for those days. (PRRB 2009-D20).
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Long Term Care Hospitals (LTCH) Clarification
December 7, 2009Long term care Hospitals (“LTCHs”) who leased space in existing hospitals could not claim inpatient capital cost reimbursement for the first two years as ‘new’ hospitals. (PRRB Hearing 2010-D2)
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New Outlier Computations for HHA in 2010
December 5, 2009HHA Medicare payments in 2010 will have outliers computed based upon a Fixed Dollar Loss (“FDL”) of .67, compared to an FDL of .89 in 2009. The FDL is adjusted for the wage index of the HHA’s location.
OPPS Payments Increase
December 3, 2009Medicare outpatient payments under OPPS will average a 2.1% increase in payments for 2010. Hospitals not participating in quality data reporting will receive 2% less.
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