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HHS/CMS | RIN: 0938-AM41 | Publication ID: Spring 2003 |
Title: ●Hospital Cost-to-Charge Ratios Used to Calculate Cost Outlier Payments Under the Medicare Short-Term Inpatient Prospective Payment System (CMS-1243-F) | |
Abstract: This proposed rule would change the methodology for determining payments for extraordinarily high-cost cases (cost outliers) made to Medicare-participating hospitals under the acute care hospital inpatient prospective payment system. We have become aware that, in some cases, hospitals' recent rates of charge increases greatly exceed their rates of cost increases. This disparity results in their cost-to-charge ratios being set too high, which in turn results in overestimation of their current costs per case. Therefore, we need to make revisions to our outlier payment methodology to correct those situations in which hospitals would otherwise receive overpayments for outlier cases due to excessive charge increases. | |
Agency: Department of Health and Human Services(HHS) | Priority: Economically Significant |
RIN Status: First time published in the Unified Agenda | Agenda Stage of Rulemaking: Final Rule Stage |
Major: Yes | Unfunded Mandates: No |
CFR Citation: 42 CFR 412.84 42 CFR 412.116 | |
Legal Authority: 42 USC 1102 of the Social Security Act 42 USC 1871 of the Social Security Act |
Legal Deadline:
None |
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Timetable:
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Regulatory Flexibility Analysis Required: Yes | Government Levels Affected: None |
Small Entities Affected: Businesses | Federalism: No |
Included in the Regulatory Plan: No | |
Agency Contact: Stephen Phillips Deputy Division Director, Center for Health Plans and Providers Department of Health and Human Services Centers for Medicare & Medicaid Services C4-07-07, 7500 Security Boulevard, Baltimore, MD 21244 Phone:410 786-4548 |