Groups react to CMS inpatient rule proposal

CMS released its proposed regulations for hospital inpatient services on April 30.

In a press release, the CMS stated that the most significant changes in the rule include payment provisions designed to improve the quality of hospital care and reduce payments for readmissions and hospital-acquired conditions.

Comments are being accepted regarding the proposal until June 30, but some groups wasted no time sharing their concerns.

Rick Pollack, executive vice president of the American Hospital Association, wrote in a press release that the proposal “implements a number of statutory requirements that would put further stress on vital care for seniors,” but said that the organization is in favor of phasing in coding cuts mandated by the American Taxpayer Relief Act of 2012, as outlined in the proposal.

“The AHA plans to offer its views on the design of an alternative payment methodology for short inpatient hospital stays,” Pollack said in the release. “We look forward to working with CMS to reach more clarity on the implementation to ICD-10. We will continue to analyze the proposed rule and will work with CMS to make improvements.”

Premier, an alliance of over 2,900 U.S. community hospitals, 56,000 non-acute healthcare facilities and 34,000 physician offices, said in a press release that the proposal neglects an important issue: “Despite mounting evidence and months of protests, Congressional queries and lawsuits, the Premier healthcare alliance is deeply disappointed that CMS failed to address fundamental problems in the 2-midnight benchmark for determining hospital inpatient payment.”

According to CMS, “the proposed rule reminds stakeholders of the existing process for requesting additional exceptions to the two-midnight benchmark.”

In its release, Premier also stated that CMS “makes no concrete proposals and provides no indication that it will imminently abandon its flawed policy in favor of a new, more equitable approach,” and shared concerns that the rules could leave hospitals more subject to audits.

The Advisory Board Company, a global research, technology and consulting firm, called the proposal a “mixed picture” for hospitals in a press release. “Altogether, the proposal would increase hospital inpatient payments in FY 2014 by $27 million. In addition, the rule would reduce disproportionate share hospital payments to 25% of the amount Medicare pays under the current policy.”

Beth Feldpush, senior vice president for policy and advocacy at the Advisory Board Company, said in the release that "CMS has ... continued to rely on the same unsound proxy that ignores uninsured individuals and instead focuses on Medicaid and low-income Medicare patients.”