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Regulation No.
CMS-1406
Title
IPPS Annual Proposed and Final Rules, and Relevant Correction Notices: Fiscal Year 2010
Display Date
07/31/2009
Year
2010
Publication Date
08/27/2009
Description
Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2010 Rates; Proposed, Final, and Relevant Correction Notices

The files associated with CMS-1406-F are located under the "Acute Inpatient - Files for Download" link in the left menu. You may also view them by clicking on the link of the same name under "Related Links Inside CMS" (below).


1. Proposed Rule 1406-P

Title: Medicare Program; Proposed Changes to the Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and Fiscal Year 2010 Rates and to the Long Term Care Hospital Prospective Payment System and Rate Year 2010 Rates

Publication Date: 05/22/2009

Description: We are proposing to revise the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems, and to implement certain provisions made by the Medicare Improvements for Patients and Providers Act of 2008 (Pub. L. 110-275) and the American Recovery and Reinvestment Act of 2009 (Pub. L. 111-5). In addition, in the Addendum to this proposed rule, we describe the proposed changes to the amounts and factors used to determine the rates for Medicare acute care hospital inpatient services for operating costs and capital related costs. These proposed changes would be applicable to discharges occurring on or after October 1, 2009. We also are setting forth the proposed update to the rate of increase limits for certain hospitals and hospital units excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. The proposed updated rate-of-increase limits would be effective for cost reporting periods beginning on or after October 1, 2009.

We are also proposing to update the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs). In the Addendum to this proposed rule, we also set forth the proposed changes to the payment rates, factors, and other payment rate policies under the LTCH PPS for rate year 2010. These proposed changes would be applicable to discharges occurring on or after October 1, 2009. In this proposed rule, we also discuss certain provisions of the American Recovery and Reinvestment Act of 2009 (Pub. L. 111-5) relating to payments to LTCHs and new LTCHs and LTCH satellite facilities, and increases in beds in existing LTCHs and LTCH satellite facilities under the LTCH PPS that will be implemented in the final rule issued for this proposed rule.

The proposed rule was published on May 22, 2009. See CMS-1406-P in the "Related Links Outside CMS" section below.


2. Supplemental Proposed Rule CMS-1406-P2

Title: Medicare Program; Proposed Rate Year (RY) 2010 Medicare Severity Long-Term Care Diagnosis‑Related Group (MS‑LTC‑DRG) Relative Weights and High‑Cost Outlier Fixed‑Loss Amount

Publication Date: 06/03/2009

Description: This supplemental proposed rule presents both proposed rate year (RY) 2010 Medicare severity-long-term care diagnosis related groups (MS‑LTC‑DRG) weights and a proposed RY 2010 high cost outlier (HCO) fixed-loss amount based on the revised fiscal year (FY) 2009 MS‑LTC‑DRG relative weights presented in an interim final rule with comment period (CMS-1337-IFC) published elsewhere in the same Federal Register.

Note: This supplemental proposed rule went on display on May 29, 2009, and was published on June 3, 2009. See CMS‑1406-P2 in the "Related Links Outside CMS" section below.

The Interim Final Rule with Comment Period (CMS-1337-IFC) entitled "Revisions to FY 2009 Medicare Severity-Long-term Care Diagnosis-Related Group (MS-LTC-DRG) Weights" can be found at http://www.cms.hhs.gov/LongTermCareHospitalPPS/LTCHPPSRN/list.asp


3. Final Rule 1406-F

Title: Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and Fiscal Year 2010 Rates; and Changes to the Long‑Term Care Hospital Prospective Payment System and Rate Years 2010 and 2009 Rates

Publication Date: 08/27/2009

Description: We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems, and to implement certain provisions made by the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA, Pub. L. 110-275) and the American Recovery and Reinvestment Act of 2009 (ARRA, Pub. L. 111-5). In addition, in the Addendum to this final rule, we describe the changes to the amounts and factors used to determine the rates for Medicare acute care hospital inpatient services for operating costs and capital‑related costs. These changes are applicable to discharges occurring on or after October 1, 2009. We also are setting forth the update to the rate‑of‑increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. The updated rate-of-increase limits are effective for cost reporting periods beginning on or after October 1, 2009.

Second, we are updating the payment policy and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) for rate year (RY) 2010, including responding to public comments received on a June 3, 2009 supplemental proposed rule relating to the proposed RY 2010 Medicare Severity Long-Term Care Diagnosis‑Related Groups (MS‑LTC-DRG) relative weights and the proposed RY 2010 high-cost outlier (HCO) fixed‑loss amount. In the Addendum to this final rule, we also set forth the changes to the payment rates, factors, and other payment rate policies under the LTCH PPS for RY 2010. These changes are applicable to discharges occurring on or after October 1, 2009. In addition, we are responding to public comments received on and finalizing a June 3, 2009 interim final rule with comment period that revised the MS‑LTC DRG relative weights for payments under the LTCH PPS for the remainder of FY 2009 (that is, from June 3, 2009, through September 30, 2009).

Third, in this final rule, we are responding to public comments we received on, and finalizing, two May 2008 interim final rules with comment period that implemented certain provisions of section 114 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA, Pub. L. 110-173) relating to payments to LTCHs and LTCH satellite facilities, the establishment of LTCHs and LTCH satellite facilities, and increases in beds in existing LTCHs and LTCH satellite facilities under the LTCH PPS.

Fourth, through an interim final rule with comment period as part of this document, we are implementing those provisions of the ARRA that amended certain provisions of section 114 of the MMSEA relating to payments to LTCHs and LTCH satellite facilities and increases in beds in existing LTCHs and LTCH satellite facilities under the LTCH PPS.


4. Correction Notice 1406-CN

Title: Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and Fiscal Year 2010 Rates; and Changes to the Long Term Care Hospital Prospective Payment System and Rate Year 2010; Corrections

Publication Date: 10/07/2009

Description: This document corrects technical errors and typographical errors that appeared in the final rules and interim final rule with comment period published in the Federal Register on August 27, 2009 entitled "Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and Fiscal Year 2010 Rates and to the Long Term Care Hospital Prospective Payment System and Rate Year 2010 Rates.


5. Notice 1406-N

Title: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and Fiscal Year 2010 Rates and to the Long Term Care Hospital Prospective Payment System and Rate Year 2010 Rates: Final Fiscal Year 2010 Wage Indices and Payment Rates Implementing the Affordable Care Act

Publication Date: 06/02/2010

Description: This notice contains the final wage indices, hospital reclassifications, payment rates, impacts, and other related tables effective for the fiscal year (FY) 2010 hospital inpatient prospective payment systems (IPPS) and rate year 2010 long-term care hospital (LTCH) prospective payment system (PPS) . The rates, tables, and impacts included in this notice reflect changes required or resulting from the implementation of several provisions of the Patient Protection and Affordable Care Act as amended by the Health Care and Education Reconciliation Act of 2010. These provisions require the extension of the expiration date for certain geographic reclassifications and special exception wage indices through September 30, 2010; and certain market basket updates for the IPPS and LTCH PPS effective April 1, 2010.


6. Notice 1406-CN2

Title: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and Fiscal Year 2010 Rates and to the Long-Term Care Hospital Prospective Payment System and Rate Year 2010 Rates: Final Fiscal Year 2010 Wage Indices and Payment Rates Implementing the Affordable Care Act; Corrections

Publication Date: 06/17/2010

Description: This document corrects technical errors in the notice entitled "Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and Fiscal Year 2010 Rates and to the Long-Term Care Hospital Prospective Payment System and Rate Year 2010 Rates: Final Fiscal Year 2010 Wage Indices and Payment Rates Implementing the Affordable Care Act" which appeared in the June 2, 2010 Federal Register.