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January 25, 2018

Four Tests Added to List of CLIA Waived Tests

In early January, the Centers for Medicare and Medicaid Services (CMS) announced new waived tests... Learn More

New and Revised Vaccine Codes Added to 2018 CPT Code Book

The American Medical Association (AMA) added and revised several vaccine CPT codes for its 201... Learn More

OIG Recommends Measures for Curbing Opioid Misuse and Fraud

Office of Inspector General testimony before the House Committee on Ways and Means in January ... Learn More

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Medical Coding News Archives

CMS Releases PPS Proposed Rules

May 4, 2010:

CMS estimates that payments to general acute care hospitals under the proposed rule for operating expenses in fiscal 2011 will decline by 0.1 percent, or $142 million, compared with fiscal 2010, taking into account all factors that would affect spending. Among the adjustments is a proposed inflation update of 2.4 percent to acute care hospital rates, which is then more than offset by an adjustment of –2.9 percentage points to recoup one-half of the estimated excess spending in fiscal 2008 and 2009 aggregate payments. Under legislation passed in 2007, CMS is required to recoup by fiscal 2012 the entire amount of fiscal 2008 and 2009 excess spending from changes in hospital coding practices.

The agency is similarly proposing to update long-term care hospital (LTCH) rates by 2.4 percent for inflation and apply an adjustment of –2.5 percentage points for the estimated increase in spending in fiscal 2008 and 2009. Based on these two proposed provisions and all the other proposed changes, CMS estimates that payments to LTCHs would increase by 0.8 percent, or $41 million.

The proposed rule was placed on display at the Federal Register dated April 19 and can be found under “Special Filings” at www.archives.gov/federal-register/public-inspection/index.html. CMS will accept comments on this proposed rule until June 18 and will respond to them in a final rule to be issued by August 1, 2010.

Deborah C. Hall
Clinical/Technical Editor

Key Terms: provisions, aggregate, LTCHs, recoup


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