2011 CMS IPPS Proposed Rule

The 2011 CMS Inpatient Prospective Payment System (IPPS) Proposed Rule was released in the April 19 Federal Register. Below are provisions that would affect CAHs:

• Reimbursement for Services of CRNAs (pg 532): CMS is proposing to allow hospitals and CAHs that are urban but have applied for and been granted rural status under Medicare law to receive reimbursement for anesthesia and related care furnished by qualified CRNAs on reasonable cost basis.
• Removal of the Annual Election Requirement on Maintaining Method II Payment (pg 560): CMS is proposing a change so that, once a CAH elects the Method II payment method for outpatient services that election remains in place until it is terminated by the CAH. 
• Clarification of Which Provider Taxes May Be Allowable Costs (pg 566): CMS currently permits certain provider taxes to be treated as allowable costs if they are related to the reasonable and necessary cost of providing patient care and are actually incurred. CMS is proposing to clarify that FI/MACs will determine whether provider taxes are allowable on a case-by-case basis, based on reasonable cost principles and will determine if a reduction of the allowable tax expenses is proper to account for payments providers receive that are associated with the assessed tax.

More information including instructions for submitting comments to CMS can be found in the Federal Register by clicking here or on CMS by clicking here. Comments to CMS on the proposed rules are due by June 18.