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HHS/CMS

RIN: 0938-AH55

Publication ID: Spring 1997

Title: Changes to the Hospital Inpatient Prospective Payment System and Fiscal Year 1998 Rates (BPD-878-P)
Abstract: Medicare pays for hospital inpatient services under a prospective payment system (PPS) in which payment is made at a predetermined specific rate for the operating and capital-related costs associated with each discharge. These rules would announce the prospective payment rates for operating and capital-related costs for FY 1998. We would also revise the Medicare hospital inpatient prospective payment systems for operating costs and capital-related costs to implement necessary changes arising from our continuing experience with the systems. In addition, we would set forth rate-of-increase limits as well as policy changes for hospitals and hospital units excluded from the prospective payment systems. These changes would be applicable to discharges occurring on or after October 1, 1997.
Agency: Department of Health and Human Services(HHS)	Priority: Other Significant
RIN Status: Previously published in the Unified Agenda	Agenda Stage of Rulemaking: Proposed Rule Stage
Major: Yes	Unfunded Mandates: No
CFR Citation: 42 CFR 412 42 CFR 413
Legal Authority: 42 USC 1395ww

Legal Deadline:

Action	Source	Description	Date
Final	Statutory	Completed: Final action merged with RIN:093-AH88.	09/01/1997
NPRM	Statutory	Completed: Final action merged with RIN:093-AH88.	05/01/1997

Statement of Need: Section 1886(e)(5) of the Social Security Act requires the Secretary to publish a proposed rule on prospective payment system policies and payment rates in the Federal Register by May 1 and a final rule by September 1.

Summary of the Legal Basis: As noted above, publication of proposed and final rules concerning hospital PPS policies and payment rates is required by law. The statute sets forth several specific requirements concerning what must be included in the PPS proposed and final rules (See sections 1886(b)(3)(B), 1886(d)(1)(A), 1886(d)(2)(H), 1886(d)(3)(A), 1886(d)(3)(E), 1886(d)(4)(C), 1886(e)(4), 1886(e)(5), and 1886(g)(1)(A) of the Act.)

Alternatives: Publication of these rules is not discretionary. Thus, no alternatives exist.

Anticipated Costs and Benefits: We are unable to estimate at this time the costs and benefits associated with these rules.

Risks: Not applicable.

Timetable:

Action	Date	FR Cite
NPRM	05/00/1997
Final Action	09/00/1997

Additional Information: BPD-878
Regulatory Flexibility Analysis Required: Yes	Government Levels Affected: Federal, State
Small Entities Affected: Businesses, Organizations
Included in the Regulatory Plan: Yes
Agency Contact: Charles Booth Director, Office of Hospital Policy, Bureau of Policy Development Department of Health and Human Services Centers for Medicare & Medicaid Services C5-02-23, 7500 Security Boulevard, Baltimore, MD 21244-1850 Phone:410 786-4487