AHA "Extremely Troubled" Over Proposed IPPS Rule

The American Hospital Association recently submitted comments (pdf) to CMS regarding the fiscal year 2013 Inpatient Prospective Payment System proposed rule, urging several changes — especially regarding documentation and coding.

In April, CMS proposed to increase Medicare's operating payments to acute-care hospitals by 0.9 percent. CMS also proposed documentation and coding adjustments to ensure the new coding system is "budget neutral." Affecting the FY 2013 IPPS update included a 1.9 percent cut from the effect of documentation and coding changes that occurred from FY 2007 to FY 2009, a 0.8 percent cut to account for a FY 2010 adjustment and a 2.9 percent increase, which CMS called a "restoration of one-time 2012 recoupment."

The AHA said these adjustments are shortchanging hospital payments using a "flawed methodology."

"AHA is extremely troubled by this proposal and by the fact that CMS continues to compare hospitals' documentation and coding practices to their documentation and coding practices under an entirely different system in FY 2007," Rick Pollack, AHA executive vice president, wrote in the letter to CMS Acting Administrator Marilyn Tavenner.

The hospital trade association also asked CMS to account for disparities in the readmission data within the Hospital Readmissions Reduction Program and to scrap a "punitive policy" that could affect the classification of a sole community hospital. CMS proposed sole community hospitals report any information that could have affected their initial classification as a sole community hospital.

More Articles on the Inpatient Prospective Payment System:

AHA: CMS Used "Flawed Methodology" in Proposed IPPS Rule

CMS Releases FY 2013 IPPS Proposed Rule: 12 Points to Know

Study Identifies "Break Even" Scores for Hospitals Under Value-Based Purchasing

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