FY 2004 Medicare Inpatient
PPS Proposed Rule
Current Status as of July 10, 2003
On May 19, 2003, the Centers for Medicare and Medicaid Services
(CMS) published its proposed rule [68 Fed Reg 27154] updating
the inpatient prospective payment system for federal fiscal
year 2004. Comments on the proposed rule were due July 8,
2003. The AAMC submitted comments
(PDF, 29 pages - 268KB) on the Proposed Rule.
Background
The proposed rule contains a number of important changes
and clarifications that could affect Medicare payments for
teaching hospitals. These include:
- Changes related to Medicare payments associated with
residents training in non-hospital sites,
- Medicare payments for nursing and allied health programs,
and
- Counting of beds and Medicaid days for purposes of calculating
Medicare disproportionate share (DSH) and indirect medical
education (IME) payments.
In addition, CMS proposes that the base per case payment
rates be updated by the full market basket increase of 3.5
as set forth in current law. The Bush Administration believes
that the update should be the market basket increase less
0.4 percentage points, as recommended by the Medicare Payment
Advisory Commission (MedPAC).
The proposed rule would increase the outlier threshold to
$50,645, up from $33,560 in fiscal year 2003. However, the
threshold is likely to be significantly lower in the final
rule pursuant to changes that will be made to Medicare outlier
policies that are soon to be published in a separate outlier
final rule.
Finally, the proposed rule would expand the number of diagnosis-related
groups (DRGs) that are subject to the post-acute transfer
policy by 19-up from the current number of ten.
Proposed Rule
The proposed rule, published May 19, 2003, in the Federal
Register, is available in text format and Portable Document
Format (PDF)
42 CFR Parts 412 and 413 Medicare Program: Proposed Changes
to the Hospital Inpatient Prospective Payment Systems and
Fiscal Year 2004 Rates; Proposed Rule
Part I [pp. 27153–27422] Text
/ PDF
This page contains documents in Portable Document Format (PDF).
The Adobe Acrobat® Reader® is required to view PDF documents. Download
Acrobat® Reader®.
Contacts
Karen Fisher, Sr. Director, Health Care Affairs
AAMC Health Care Affairs
kfisher@aamc.org
(202) 862-6140
|
