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HHS/CMS

RIN: 0938-AI22

Publication ID: Fall 1997

Title: ●Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 1999 Rates (HCFA-1001-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 1999 that reflect changes made by the Balanced Budget Act of 1997. We would also revise the Medicare hospital inpatient prospective payment systems for operating and capital-related costs to implement necessary changes arising from our continuing experience with the systems.
Agency: Department of Health and Human Services(HHS)	Priority: Other Significant
RIN Status: First time 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		08/01/1998
NPRM	Statutory		04/01/1998

Statement of Need: Section 1886(e)(5) of the Social Security Act, as amended by section 4644(a)(1) and (b)(1) of the Balanced Budget Act of 1997, requires the Secretary to publish a proposed rule on prospective payment system policies and payment rates in the Federal Register by April 1 and a final rule by August 1.

Summary of the Legal Basis: As noted above, publication of proposed and final rules concerning hospital prospective payment system policies and payment rates is required by law. The statute sets forth several specific requirements concerning what must be included in the prospective payment system 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)(5), and 1886(G)(1)(A).)

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

Anticipated Costs and Benefits: Estimates of the economic impact that will stem from these rules have not yet been completed.

Risks: Not applicable.

Timetable:

Action	Date	FR Cite
NPRM	04/00/1998
Final Action	08/00/1998

Additional Information: HCFA-1001
Regulatory Flexibility Analysis Required: Yes	Government Levels Affected: Federal
Small Entities Affected: Businesses, Organizations
Included in the Regulatory Plan: Yes
Agency Contact: Tzvi Hefter Director, Division of Acute Care Department of Health and Human Services Centers for Medicare & Medicaid Services C4-07-07, Center for Medicare Management, 7500 Security Boulevard, C4-07-07, Baltimore, MD 21244 Phone:410 786-4487