AOR/BOR File [ZIP, 1MB]
: This zip file for the FY 2020 proposed rule contains one excel spreadsheet with multiple tabs: one for the After Outliers Removed (AOR) and one for the Before Outliers Removed (BOR). There are also two tabs containing the variable descriptions. The variables in these files are used in the calculations of the relative weights as well as other calculations for the inpatient PPS. All text files in the zip file are for 508 compliance.
Case Mix Index File [ZIP, 44KB]
: This file contains the non-transfer adjusted case mix index (CMI) based on the MS-DRGs billed on the claim in the year the claim was incurred (that is, during FY 2018, using the V35 Grouper).
FY 2020 Proposed Rule: HCRIS Data File - Opens in a new window
: CMS uses hospital cost report data from the Medicare Cost Report, Hospital Form 2552-10, to calculate the Cost-to-Charge Ratios (CCRs) used in the cost based MS-DRG relative weight methodology. The database for the Medicare cost reports is the Healthcare Cost Report Information System (HCRIS). The CCRs used in the calculation of the MS‑DRG relative weights for the FY 2020 IPPS Proposed Rule are derived from the December 31, 2018 quarterly update of the FY 2017 HCRIS. (HCRIS is updated on a quarterly basis).
FY 2020 Proposed Rule Wage Index PUFs; S3 Part II and Occ Mix Data
FY 2020 Proposed Rule Average Hourly Wage by Provider and CBSA Public Use File
FY 2020 Proposed Rule Occupational Mix Adjusted and Unadjusted Average Hourly Wages and Occupational Mix Factor by Provider
FY 2020 Proposed Rule Occupational Mix Adjusted and Unadjusted Average Hourly Wages and Pre-Reclass Wage Indexes by CBSA
FY 2020 Proposed Rule AHW by Provider Area Listing
FY 2020 IPPS Proposed Rule: Medicare DSH Supplemental Data File [ZIP, 953KB]
: This spreadsheet has 7 tabs (text files for each tab are included for Section 508 compliance): The first tab is the File Layout for second tab of the spreadsheet. The second tab contains the proposed rule FY 2020 Factor 3 and data used to calculate Factor 3 to implement Section 3133 of the ACA, Improvements to Medicare DSH Payments. The third tab contains a list of hospitals that have undergone a merger where the data of the merging hospitals have been combined to calculate the Factor 3 for the surviving hospital for FY 2020. The fourth through sixth tabs are similar to the first three tabs, except reflect the alternative policy under consideration. The seventh tab contains the Medicare DSH estimates to support the calculation of the proposed Factor 1.
List of Lugar Counties [ZIP, 16KB]
: This table lists each Lugar county that is deemed urban under section 1886(d)(8)(B) of the Act. It also indicates which counties map to a different CBSA per our proposal of including outlying counties in the out commuting analysis.
Lugar Hospitals in Counties that Qualify for an Outmigration Adjustment for FY 2020 [ZIP, 12KB]
: This table lists each Lugar hospital (deemed urban under section 1886(d)(8)(B) of the Act) that is located in a county that qualifies for an outmigration adjustment; the 3-year period for which the hospital is eligible for the outmigration adjustment; and whether or not the hospital accepted the outmigration adjustment in lieu of its urban status for each year of its 3-year eligibility. Please note that in the FY 2012 IPPS final rule, CMS finalized a policy that allows a Lugar hospital that is eligible for and accepts the outmigration adjustment to automatically waive its urban status for the 3-year period for which the outmigration adjustment is effective.
Hospital Readmissions Reduction Program Supplemental Data File: While the proposed rule discusses the supplemental data file, we have not updated the supplemental data file because the proposed readmissions payment adjustment factors are not available at this time because hospitals have not yet had the opportunity to review and correct the data before the data are made public under our policy regarding the reporting of hospital-specific data, and the information would be the same as the FY 2019 final rule supplemental data file. Therefore, we refer readers to the FY 2019 IPPS/LTCH PPS final rule supplemental file, which has the most recent finalized payment adjustment factor components and is the same data as would have been used to create the FY 2020 IPPS/LTCH PPS proposed rule supplemental data file.