CMS Issues Final Rule Implementing Hospital Readmissions Reduction Program

Jackson Walker
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On June 28, 2012, the U.S. Supreme Court issued its ruling in Department of Health and Human Services v. Florida, upholding the Affordable Care Act (the "Act") as constitutional. Since then, and even since its passage in March of 2010, various states and federal agencies have been busy preparing to implement the Act.

On August 1, 2012, the Centers for Medicare and Medicaid Services ("CMS"), issued its hospital inpatient prospective payment system("IPPS") final rule which, among other things, implements key elements of the Act's Hospital Readmissions Reduction Program. Pursuant to the rule, set to become effective on October 1, 2012, CMS will begin reducing payments for discharges to IPPS hospitals with excess readmissions of selected applicable conditions. While CMS intends to expand the number of applicable conditions in further rulemaking, the applicable conditions set forth in the final rule include acute myocardial infarction, heart failure, and pneumonia.

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