On December 31, 2008, CMS published a notice correcting a number of technical and typographical errors in the November 19, 2008 final Medicare physician fee schedule rule for calendar year 2009. In addition, on December 30, 2008, CMS published a notice correcting certain wage data included in the October 3, 2008 final FY 2009 Medicare hospital inpatient prospective payment system rule.
On December 2, 2008, CMS proposed three national coverage determinations (NCDs) to deny Medicare coverage of certain types of serious, preventable surgical errors. Specifically, under the proposed NCDs, Medicare would not cover: (1) wrong surgical or other invasive procedures performed on a patient; (2) surgical or other invasive procedures performed on the wrong body part; or (3) surgical or other invasive procedures performed on the wrong patient. The coverage policy is intended to complement CMS’s hospital-acquired conditions policy, under which Medicare will not make higher payments to hospitals for care associated with certain reasonably-preventable conditions unless the condition were reported as present on admission. CMS will accept comments on the proposed coverage policies until January 1, 2009.
On December 3, 2008, CMS issued FY 2009 hospital wage index changes to implement Section 124 of the Medicare Improvement for Patients and Providers Act of 2008 (MIPPA). The notice contains revised final wage indices and hospital reclassifications for 27 hospitals and are applicable for discharges beginning October 1, 2008.
On February 17, 2009, CMS is hosting a town hall meeting to discuss FY 2010 applications for add-on payments for new medical services and technologies under the Medicare hospital inpatient prospective payment system (IPPS).
On November 19, 2008, Senate Finance Committee Chairman Max Baucus and Ranking Member Chuck Grassley released a discussion draft of legislation that would establish a value-based purchasing program for Medicare inpatient hospital care. Under the plan, Medicare payments would be linked to hospital performance -- rather than just reporting -- on certain quality measures. The initial performance measures focus on treatment of heart attacks, heart failure, pneumonia, and surgical care. The budget-neutral plan would be phased in over five years, beginning in FY 2012, with full implementation beginning in FY 2016. Comments on the draft will be accepted through December 15, 2008.
On December 18, 2008, CMS and the Centers for Disease Control and Prevention are holding a listening session to solicit informal comments on hospital-acquired conditions and hospital outpatient healthcare-associated conditions in preparation for the fiscal year 2010 inpatient prospective payment systems and calendar year 2010 OPPS rulemaking processes. Hospitals, hospital associations, representatives of consumer purchasers, payors of health care services, and other interested parties are invited to attend and make comments in person or in writing. It also will be possible to listen to the session by teleconference. Registration is required.
On October 3, 2008, CMS published a notice updating the final Medicare hospital inpatient prospective payment system (IPPS) wage indices, hospital reclassifications, payment rates, and other tables for fiscal year (FY) 2009, which began October 1, 2008. The data reflects the extension of the expiration date for certain geographic reclassifications and special exception wage indices as required by the Medicare Improvement for Patients and Providers Act of 2008 (MIPPA). In a related development, CMS published a separate notice correcting a series of technical and typographical errors that appeared in August 19, 2008 IPPS final rule, including corrections of regulatory language related to physician self-referral provisions.
CMS has announced that because of the impact of recent hurricanes, it will grant a data submission waiver to IPPS hospitals in selected counties of Louisiana and Texas that are unable to meet the submission of quality data requirements for the Reporting Hospital Quality Data for Annual Payment Update (RHQDAPU) for FY 2010. Hospitals that have questions about this process should contact their local Quality Improvement Organization.
The GAO has issued a report entitled “Health-Care-Associated (HAI) Infections in Hospitals: An Overview of State Reporting Programs and Individual Hospital Initiatives to Reduce Certain Infections." The report looks at (1) the design and implementation of state HAI public reporting systems, (2) hospital initiatives to reduce MRSA infections, and (3) the experience of certain early-adopting hospitals in overcoming challenges to implement such initiatives.
CMS has posted the fiscal year 2010 Medicare inpatient prospective payment system (IPPS) new technology application on its website. The deadline for FY 2010 applications is November 17, 2008.
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