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Inpatient Prospective Payment System (IPPS) Rules and Comments

Under Medicare Part A, payments to health facilities for acute care hospital inpatient stays are based on set rates.

The inpatient prospective payment system (IPPS) categorizes patient cases into diagnosis-related groups (DRGs). DRGs are weighted based on the cost and care resources needed to treat each group of Medicare beneficiaries.

It is important that essential hospitals understand this system. Hospitals that treat a large share of low-income patients receive add-on payments to the amount designated by IPPS. Disproportionate share hospital (DSH) adjustments is one example of an IPPS add-on payment. Teaching hospitals also receive add-ons, based on resident to average daily census ratios.

The IPPS rule is updated annually. Comment periods open prior to implementation of the final rule.

FY2014

Final Rule

Published August 2013.

Association Comments on Proposed Rule

Submitted June 2013.

Proposed Rule

Published April 2013. This rule includes provisions related to the Affordable Care Act’s Medicare DSH payment cuts.

FY2013

Final Rule

Published October 2012. This rule includes provisions related to readmissions.

Association Comments on Proposed Rule

Submitted June 2012.

Proposed Rule

Published April 2012. This rule includes provisions related to readmissions.

 

 

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