CMS payment rule correction includes final FY 2015 readmissions penalties

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The Centers for Medicare & Medicaid Services today issued a correction notice to the fiscal year 2015 inpatient and long-term care hospital prospective payment system final rule. The notice includes a number of technical corrections to the calculation of hospital operating and capital rates, as well as estimated financial impacts. The notice also includes a table of the final FY 2015 readmission payment adjustment factors for hospitals under the Hospital Readmissions Reduction Program. These payment adjustment factors will be applied to hospital discharges on or after Oct. 1, and reflect hospital performance on the program. CMS indicates the technical corrections to payments raised estimated FY 2015 readmissions penalties by $4 million, to $428 million. CMS also states that it made a “technical error” in estimating Hospital-Acquired Condition Reduction Program penalties in the FY 2015 inpatient PPS final rule. In the correction notice, CMS raises its estimate of FY 2015 HAC penalties from $369 million to $373 million. However, the correction notice does not include the final list of hospitals that will receive FY 2015 HAC penalties. AHA staff are analyzing this notice to assess implications for member hospitals.

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