Inpatient pay proposal is 'woefully inadequate,' hospitals say

The American Hospital Association told CMS Administrator Chiquita Brooks-LaSure that the agency's proposed 3.2 percent funding increase for inpatient payments is "woefully inadequate."

The hospital group said in a June 17 letter to the administrator it is particularly concerned about the inadequacy of the proposal "given the extreme inflationary environment in which we continue to operate."  

The group is urging CMS to use its special exceptions and adjustments authority to make a retrospective adjustment to account for the difference between the market basket update that was implemented in 2022 and what the market basket is currently projected to be in 2023. It is also asking the agency to eliminate the productivity cut for 2023.  

The group said it is also concerned about the agency's proposed cuts to disproportionate share hospital payments and the lack of transparency in the underlying calculations.  

"Specifically, we disagree with the agency's estimates of both the inpatient discharge volume for (fiscal year) 2023 and the number of uninsured," the group said in the letter. "For instance, signs of volume recovery are emerging and it is clear that a large increase in the number of the uninsured, not a decrease, will occur as the public health emergency coverage provisions begin to unwind." 

The group is asking CMS to use more recent data and update its estimates of the disproportionate share hospital amount to more accurately reflect both the discharge volume and uninsured rate. 

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