CMS proposes 2022 Inpatient Prospective Payment Hospital Rule

April 29, 2021

On April 27, the Centers for Medicare & Medicaid Services (CMS) issued its proposed FY 2022 Inpatient Prospective Payment System (IPPS) rule. The rule would increase Medicare inpatient prospective payment system rates by a net 2.8 percent for hospitals that meet EHR meaningful use criteria and submit quality measure data. Other highlights are:

  • CMS proposes to repeal the requirement it had finalized last year that hospitals report negotiated rates with Medicare Advantage plans on their Medicare cost report for purposes of CMS rate-setting.
  • Under the proposed rule, CMS would use FY 2019 data, rather than FY 2020 data, in approximating expected FY 2022 inpatient hospital utilization for weight-setting purposes, in recognition of the impact of the COVID-19 emergency on inpatient utilization.
  • CMS proposes to extend its “New COVID-19 Treatments Add-on Payments” through the end of the fiscal year in which the public health emergency ends.
  • Under the proposed rule, CMS would apply temporary adjustments to its hospital quality measurement and value programs to avoid undue penalties due to the emergency.
  • CMS also proposes to implement several provisions of the Consolidated Appropriations Act, including distributing 1,000 additional physician residency slots to qualifying hospitals, to address workforce shortages.
  • The proposed rule includes enhanced reporting requirements, including a new COVID-19 Vaccination Coverage among Healthcare Personnel (HCP) Measure, Syndromic Surveillance Reporting, Immunization Registry Reporting, Electronic Case Reporting and Electronic Reportable Laboratory Result Reporting.

WSHA is preparing a detailed summary of the proposed rule and hospital-specific impact analyses, which will be sent within the next few weeks to hospital chief financial officers and finance staff. CMS will accept comments on the proposed rule through June 28.


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