FY 2013 IPPS Final Rule Released


On August 1, 2012, the Centers for Medicare and Medicaid Services (“CMS”) released the fiscal year (FY) 2013 Inpatient Prospective Payment System (“PPS”) Final Rule (the “Rule”). The Rule contains several updates to Affordable Care Act (“ACA”) programs implemented in prior rulemakings. The Rule also finalized the market basket update of 2.8% for IPPS hospitals.1 This e-alert focuses on many of the programs meant to improve quality of care for patients. For more information on these subjects, you can access other Polsinelli Shughart Updates here.

Hospital Inpatient Quality Reporting (IQR) Program -

In the Rule, CMS proposes programmatic changes to the Hospital IQR program for the FY 2015 payment determination and subsequent years. The IQR program requires that IPPS hospitals successfully report on 55 measures in FY 2012, 57 in FY 2013, 55 in FY 2014, 59 in FY 2015, and 60 in FY 2016. Providers that do not successfully report face a 2% reduction in their market basket update. For 2013, this means hospitals that fail to report will only see a 0.8% increase in their market basket.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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