Industry News

CMS Releases IPPS 2013 Final Rule

The Centers for Medicare & Medicaid Services (CMS) released the final rule on the hospital Inpatient Prospective Patient System (IPPS) for fiscal year (FY) 2013. The rule will increase Medicare payment rates for general acute care hospitals and long-term care hospitals (LTCHs).

Notably, CMS will simplify the Inpatient Quality Reporting Program (IQR Program) by reducing the number of reportable measures from 72 to 59. In addition, the final rule will implement a new outcome measure in the Hospital Value-Based Purchasing Program that will encourage hospitals to avoid certain types of life-threatening blood infections. Furthermore, under the final rule, the 2013 hospital acquire conditions list will include a sub-category for Surgical Site Infection Following Cardiac Implantable Electronic Device (CIED) and a new category for Latrogenic Pneumothorax with Venous Catheterization. The IPPS rule further clarifies requirements for maintaining graduate medical education resident slots, billing for hospital routine services, and the moratorium on the 25-percent payment threshold for LTCHs

The final rule will take effect on October 1, 2012.

The IPPS Final Rule can be accessed here: http://www.gpo.gov/fdsys/pkg/FR-2012-08-31/pdf/2012-19079.pdf.


Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals’ Resident Caps for Graduate Medical Education Payment Purposes; Quality Reporting Requirements for Specific Providers and for Ambulatory Surgical Centers, 77 Fed. Reg. 10, 53258, 53265 (Aug. 31, 2012).