CMS pitches inpatient payment rule for 2024: 10 things to know

CMS released its annual Inpatient Prospective Payment System proposed rule April 10, which proposes a reimbursement boost for acute care hospitals. 

Here are 10 things to know about the proposed rule: 

1. Payment rate update. Under the proposed rule, acute care hospitals that report quality data and are meaningful users of EHRs will see a net 2.8 percent increase in payments in fiscal year 2024, compared to 2023. CMS said the rate adjustment will mean hospitals see an increase of about $3.3 billion in fiscal 2024. 

2. Disproportionate share hospital payments. CMS projects Medicare disproportionate share hospital payments and Medicare uncompensated care payments will decrease in fiscal 2024 by a combined $115 million. 

3. Long-term care hospitals. CMS is projecting an overall decrease of 2.5 percent — $59 million — in standard payments to long-term care hospitals in fiscal 2024 compared to 2023.  

4. Physician-owned hospitals. CMS said for a hospital to submit and receive Medicare payment for services referred by a physician owner or investor, the hospital must satisfy all of the requirements of either the whole hospital exception or the rural provider exception to the Stark Law. 

To use the rural provider or whole hospital exception, a hospital may not increase the aggregate number of operating rooms, procedure rooms and beds above the level it was licensed for on March 23, 2010, unless CMS has granted an exception.  

5. SDOH codes. CMS is proposing to change the severity designation of three ICD-10-CM diagnosis codes describing homelessness from non-complication or comorbidity to  complication or comorbidity.   

6. Health equity. CMS is proposing adding 15 new health equity hospital categorizations for the fiscal 2024 IPPS payment impacts. 

7. Rural emergency hospitals. CMS is proposing changes to graduate medical education payments for training to address growing concerns over rural hospital closures. The changes would allow rural hospitals to serve as training sites for Medicare graduate medical education purposes after they become rural emergency hospitals. 

8. New COVID-19 treatments add-on payments. If the COVID-19 public health emergency ends in May as planned, add-on payment for discharges involving eligible products will expire at the end of fiscal 2023. 

9. Safety-net hospital request for information. CMS is seeking public input on the unique challenge faced by safety-net hospitals and the patients they serve, as well as potential approaches to help the hospitals meet those challenges. 

10. Comment period. CMS will accept comments on the proposed rule through June 9. 

Read CMS' fact sheet on the proposed rule here

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