News & Analysis as of

Reimbursements Inpatient Prospective Payment System (IPPS)

McDermott+

Inpatient Prospective Payment System (IPPS) Data Dashboard

McDermott+ on

Updated to include Medicare claims data thru Q4 2024. What is the cost of a knee implant in the inpatient setting? How much does Medicare pay for different types of cardiac valve procedures? How have Medicare inpatient...more

Holland & Knight LLP

CMS Releases Fiscal Year 2026 IPPS and LTCH Proposed Rule

Holland & Knight LLP on

The Centers for Medicare & Medicaid Services (CMS) on April 11, 2025, issued the proposed fiscal year (FY) 2026 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Acute Care Hospital (LTCH) Rule...more

McDermott+

Inpatient Prospective Payment System (IPPS) Data Dashboard

McDermott+ on

Updated to include Medicare claims data thru Q3 2024. What is the cost of a knee implant in the inpatient setting? How much does Medicare pay for different types of cardiac valve procedures? How have Medicare inpatient...more

Ropes & Gray LLP

Hospital and Health Systems Reimbursement Check - NOVEMBER 2024

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Ropes & Gray attorneys share their analysis of administrative and court litigation, regulatory developments, key developments affecting federal program payments to hospitals and health systems, and other reimbursement-related...more

King & Spalding

CMS Issues IPPS and LTCH Final Rule for FY 2025

King & Spalding on

On August 1, 2024, CMS filed a display copy of its final rule for Fiscal Year (FY) 2025 pertaining to the Inpatient Prospective Payment Systems (IPPS) for general acute care hospitals and long-term care hospitals (LTCHs) (the...more

Ankura

A Financially Feasible Inpatient Solution is Possible… If You Are in the Right Market and Deploy the Right Strategy

Ankura on

Many health systems are not currently considering inpatient capital projects because it is incredibly difficult to generate an appropriate profit margin with the current market pressures around reimbursement, rising expenses,...more

McDermott Will & Emery

Hospital Reimbursement Opportunity Remains After CMS Decides Not to Finalize DSH Payment Calculation Changes

McDermott Will & Emery on

On December 17, 2021, the Centers for Medicare & Medicaid Services (CMS) released the fiscal year (FY) 2022 inpatient prospective payment system (IPPS) final rule. In light of the significant volume of comments, CMS declined...more

King & Spalding

CMS Declines to Adopt Policy Reducing Reimbursement for “Medicare” Organs for Transplant Hospitals and Organ Procurement...

King & Spalding on

On December 17, 2021, CMS issued a final rule with comment period addressing certain provisions of the fiscal year 2022 IPPS/LTCH PPS proposed rule that were designated to be addressed in “future rulemaking,” including...more

Baker Donelson

CMS Revises Definition of Displaced Residents Counted for Temporary Transfers of GME Cap Slots

Baker Donelson on

In the fiscal year (FY) 2021 inpatient prospective payment systems (IPPS) final rule, CMS finalized policies to define more accurately "displaced residents" from closing hospitals and programs. By revising this definition,...more

Baker Donelson

CMS Issues Proposed Retroactive DSH Rule Requiring Medicare Part C Days in the Medicare Fraction and Blocks Providers' Appeals...

Baker Donelson on

In a Federal Register publication last month, CMS announced that it intended to retroactively adopt a change to its Medicare disproportionate share hospital (DSH) regulation. Specifically, it proposed adopting a 2014 change...more

King & Spalding

Eighth Circuit Upholds CMS’s Methodology for Calculating the Volume Decrease Adjustment for Cost Reporting Periods Preceding...

King & Spalding on

Last week, the United States Court of Appeals for the Eighth Circuit issued a consolidated opinion for three cases in which it upheld the methodology that CMS used to calculate the volume decrease adjustment (VDA) for...more

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