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HHS/CMS RIN: 0938-AM41 Publication ID: Fall 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 final rule revises 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. CMS has become aware that, in some cases, hospitals' recent rates of charge increases greatly exceed their rates of cost increases. 
Agency: Department of Health and Human Services(HHS)  Priority: Economically Significant 
RIN Status: Previously published in the Unified Agenda Agenda Stage of Rulemaking: Completed Actions 
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
Timetable:
Action Date FR Cite
NPRM  03/05/2003  68 FR 10420   
NPRM Comment Period End  04/04/2003    
Final Action  06/09/2003  68 FR 34494   
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