More Specific Device Cost Data May Inform Medicare Inpatient Payments In FY 2014
This article was originally published in The Pink Sheet Daily
CMS says it is finally ready to start relying on a specific cost-report line that it created five years ago for implantable devices, as well as distinct lines for cardiac catheterizations, CT scans and MRIs established more recently, to calculate hospital inpatient payments. It’s a positive for implantables and a negative for advanced imaging payments.
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The agency plans to be more selective about which hospital readmissions count toward a potential payment reduction in fiscal year 2014, according to its inpatient payment proposal. CMS also proposes hip and knee replacements as a new category of hospital admission to be included in the readmissions reduction program.
The agency finalized its decision to base its payment calculations on data that separates hospital charges for implantable devices from those for lower-priced medical supplies in the final 2013 outpatient rule.
CMS is putting off for at least one more year plans to factor data into its reimbursement calculations that companies believe will lead to fairer payment rates for implantable devices. Some in industry are demanding more action.