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2014 Inpatient Prospective Payment System Final Rule

2014 Inpatient Prospective Payment System Final Rule September 4, 2013

The 2014 Inpatient Prospective Payment System Final Rule was published on August 19th.

Key provisions that were finalized include:

  • Inpatient Admission – Medicare adopted the “2 midnight” proposal.  Contractors will now presume inpatient stays of less than 2 midnights as not reasonable and necessary (with relatively few exceptions).  Conversely, stays that span more than 2 midnights will be presumed to be reasonable and necessary.
  • Part B Inpatient Billing – Medicare adopted the proposal to allow hospitals to be paid for Part B services when a Part A claim for inpatient services is denied as not reasonable and necessary.
  • Payment Reduction Methods – Medicare has adopted and outlined the payment reduction methods that will be applied for both readmissions and hospital acquired conditions (HACs) starting in October 2014.
  • Transition to ICD10 – Medicare continues to outline the steps for transition to ICD-10 which becomes effective October 2014.

HC Healthcare Consulting has a team of experts that are available to assist you with revisions to your processes, policies and procedures related to these changes.  We are also available to provide your administrative, clinical, coding and billing staff with customized education and training regarding these critical Medicare updates.  We recommend a thorough review of the Final IPPS rule to identify all of the key changes that affect your organization.

The complete rule can be viewed at http://www.gpo.gov/fdsys/pkg/FR-2013-08-19/pdf/2013-18956.pdf

DISCLAIMER:  This post contains only summary information and highlights; it should be read in conjunction with the full article or document provided as a link.  Any advice or recommendations given is general and specific questions should be directed to professional counsel.

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