CMS Releases FFY 2019 proposed Inpatient Prospective Payment System Rule

May 9, 2018

On April 24, 2018, the Centers for Medicare and Medicaid Services (CMS) released the proposed federal fiscal year (FFY) 2019 payment rule for Medicare Inpatient Prospective Payment System (IPPS) hospitals. Hospital-specific analyses of estimated financial impact are being prepared and will be sent to the Chief Financial Officer or designated finance staff person for each applicable member hospital in the next few weeks. A summary of the proposed rule is here. The proposed rule includes:

  • A 2.8 percent marketbasket increase, largely offset by mandated productivity and coding related reductions;
  • Various changes relating to calculation of wage index;
  • Changes to Medicare DSH payment calculation as CMS transitions to greater use of Cost Report S-10 information. DSH dollars available to hospitals are expected to increase in FFY 2019 under the Affordable Care Act formula due to a projected increase in the percentage of uninsured individuals;
  • Changes to payment policy for patients transferred from acute care to hospice care
  • Information regarding changes to low-volume hospital adjustment and MAC notification requirements;
  • Reductions in the number of quality measures reported to CMS; and
  • Online posting of “standard” hospital charges. Effective January 1, 2019 hospitals will be required to post online in a machine-readable format their standard charges, which could be the chargemaster or another form of the hospital’s choice. CMS is seeking public comment on how to define “standard charges” and what form of the information would be most beneficial to patients.

(Andrew Busz,


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