1. CMS-1808-P
Date of Display: April 10, 2024
Description: Medicare Program; Proposed Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long‑Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2025 Rates; Quality Programs and Medicare Promoting Interoperability Program Requirements for Eligible Hospitals and Critical Access Hospitals; Rural Emergency Hospital and Physician-Owned Hospital Requirements; and Disclosures of Ownership Comment Solicitation
Comment Period: To be assured consideration, comments must be received no later than 5 p.m. EDT on June 10, 2024.
2. CMS-1808-F
Date of Display: August 1, 2024
Description: Medicare and Medicaid Programs and the Children’s Health Insurance Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2025 Rates; Quality Programs Requirements; and Other Policy Changes
3. CMS-1808-CN2
Date of Display: September 27, 2024
Date of Publication: TBD
Title: Medicare and Medicaid Programs and the Children’s Health Insurance Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2025 Rates; Quality Programs Requirements; and Other Policy Changes; Correction
4. CMS-1808-IFC
Date of Display: September 30, 2024
Date of Publication: October 3, 2024
Comment Period: To be assured consideration, comments must be received no later than 11:59 p.m. EDT on November 29, 2024
Title: Medicare Program; Changes to the Fiscal Year 2025 Hospital Inpatient Prospective Payment System (IPPS) Rates Due to Court Decision
Summary: In the FY 2020 Inpatient Prospective Payment System/Long-Term Care Hospital (IPPS/LTCH) PPS final rule (84 FR 42325 through 42339), CMS finalized a policy to address increasing wage index disparities between low wage index hospitals and other hospitals. We explained that those growing disparities are likely caused, at least in part, by the use of historical wage data to prospectively set hospitals’ wage indexes. That lag between when hospitals increase wages and when those wage increases are reflected in the historical data creates barriers to hospitals with low wage index values being able to increase employee compensation, because those hospitals will not receive corresponding increases in their Medicare payment for several years (84 FR 42327).
Accordingly, CMS finalized a policy that provided certain low wage index hospitals with an opportunity to increase employee compensation without the usual lag in those increases being reflected in the calculation of the wage index (as they would expect to do if not for the lag). The agency accomplished this by temporarily increasing the wage index values for certain hospitals with low wage index values and doing so in a budget neutral manner through an adjustment applied to the standardized amounts for all hospitals. We increased the wage index for hospitals with a wage index value below the 25th percentile wage index value for a fiscal year by half the difference between the otherwise applicable final wage index value for a year for that hospital and the 25th percentile wage index value for that year across all hospitals (the low wage index hospital policy).
On July 23, 2024, the Court of Appeals for the D.C. Circuit held that Department of Health and Human Services lacked authority under section 1886(d)(3)(E) of the Act or under the “adjustments” language of section 1886(d)(5)(I)(i) of the Act to adopt the low wage index hospital policy for FY 2020, and that the policy and related budget neutrality adjustment must be vacated. (Bridgeport Hosp. v. Becerra, 108 F.4th 882, 887-91 & n.6 (D.C. Cir. 2024))
This Interim Final Action with Comment (IFC) implements revised Medicare IPPS wage index values for FY 2025, establishes a transition for low wage hospitals significantly impacted by those revisions, and makes conforming changes to the IPPS payment rates for FY 2025. These changes reflect the removal of the low wage index hospital policy following the D.C Circuit Court decision in Bridgeport Hosp. v. Becerra. This IFC also makes conforming changes to IPPS rates and factors used to determine certain payments under the Long-Term Care Hospital Prospective Payment System (LTCH PPS).