2022 IPPS Proposed Rule

On April 27, 2021 CMS issued the proposed rule for FY 2022 Medicare Hospital Inpatient Prospective Payment System (IPPS). The deadline for comment is June 28, 2021. The proposed rule contains a number of notable items including:

  • Proposed overall increase in IPPS payments of approximately 2.8%
  • Proposal to repeal the price transparency requirement for hospitals to report their median payer-specific negotiated rates for inpatient services by MS-DRG for Medicare Advantage organizations
  • Proposed +0.5 percent adjustment to the standardized amount of Medicare payments to acute care hospitals for MS-DRG documentation and coding changes
  • Proposed changes to the New COVID-19 Treatments Add-on Payment (NCTAP) extended through the end of the fiscal year in which the PHE ends
  • Proposed reporting of COVID-19 vaccination coverage among health care personnel with a reporting period from October1, 2021-December 31, 2021
  • Proposed changes to the MS-DRG list: 58 New, 96 Deleted
  • Proposed changes to the CC list: 9 New
  • Proposed changes to the MCC list: 8 New, 2 Deleted
  • Proposed ICD-10 Updates: CM 153 New, 22 Revised, 30 Deleted; PCS 127 New, 6 Deleted
  • Changes to policies for the Hospital Readmissions Reduction Program
  • Proposed changes to the Hospital Inpatient Quality Reporting (IQR) Program

We recommend you read the complete Proposed Rule to understand the changes and potential impact to your facility. 

The proposed rule can be accessed here:

CMS Fact Sheet: https://www.cms.gov/newsroom/fact-sheets/fiscal-year-fy-2022-medicare-hospital-inpatient-prospective-payment-system-ipps-and-long-term-care

HBE’s team of coding and compliance experts is available to assist you external reviews of your documentation, coding and reimbursement as well as providing customized education and training for your staff.  We are also available to provide assistance with conducting risk assessments, internal investigations and policy and procedure development.  

DISCLAIMER:  This newsletter 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 are general and specific questions should be directed to professional counsel

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