CMS IPPS 2012 Rules

CMS released a display copy of the 2012 IPPS final rule. In the rule, CMS is modifying its regulations to allow reasonable cost-based payment for ambulance services furnished by a CAH or by an entity owned and operated by the CAH as long as there is no other ambulance provider or supplier within a 35-mile drive of the CAH. CMS is also amending its regulations to permit Medicare to pay an entity owned and operated by a CAH based on 101 percent of reasonable costs for its ambulance services even if the entity is further than a 35-mile drive from the CAH, as long as it is the closest provider or supplier of ambulance services to the CAH. Other changes include add discharge status code 66 (Discharged/Transferred to CAH) to the MS–DRG GROUPER logic for MS–DRG 789 for transfer from IPPS Hospital to CAH, and allowing CRNA pass-through payments for hospitals and CAHs that have reclassified as rural under the regulations at § 412.103. To access the CMS IPPS 2012 Fact Sheet summarizing the changes including a link to the final rule, click here.