CMS denies Partners' appeal to rectify math errors

Brooke Murphy -

CMS said it will not allow Boston-based Partners HealthCare to resubmit paperwork for 19-bed Nantucket (Mass.) Cottage Hospital that, if it had been filed correctly, would have resulted in higher Medicare payments to Massachusetts hospitals.

CMS' decision to deny Partners' resubmission request was included in CMS' inpatient prospective payment systems rule. In the rule, CMS said it refused to allow the corrections because the hospital missed the original submission deadline.

"We have consistently stated in annual IPPS rulemaking that hospitals that do not meet the procedural deadlines set forth in the IPPS rule will not be afforded a later opportunity to submit wage index data corrections or to dispute the Medicare administrative contractor's decision with respect to requested changes," wrote CMS in the rule. "Therefore, we are not incorporating the adjustments requested by Nantucket Cottage Hospital for the FY 2017 final rule wage index."

Under hospital payment rules, Medicare is required to reimburse employee wages at urban hospitals at the baseline set at rural hospitals in the state. Nantucket Cottage Hospital typically sets the floor for wages at hospitals across Massachusetts because it is the only rural hospital in the state.

Last year, the Nantucket-based hospital provided data that underestimated its wages, dragging down payments for the entire state. Partners identified the errors in mid- to late March, and sent corrected numbers April 5, almost two months after the deadline for submitting corrections.

Massachusetts hospitals stand to lose a total of $160 million in Medicare funding next year.

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