Assessing the FY 1989 change in Medicare PPS outlier policy

Medicare program; prospective payment system and consolidated billing for skilled nursing facilities for FY 2015. Final rule.

This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2015. In addition, it adopts the most recent Office of Management and Budget (OMB) statistical area delineations to identify a facility's urban or rural status for the purpose of determining which set of rate tables will apply to the facility, and ...

Medicare program; home health prospective payment system rate update for calendar year 2011; changes in certification requirements for home health agencies and hospices. Final rule.

This final rule sets forth an update to the Home Health Prospective Payment System (HH PPS) rates, including: the national standardized 60-day episode rates, the national per-visit rates, the nonroutine medical supply (NRS) conversion factors, and the low utilization payment amount (LUPA) add-on payment amounts, under the Medicare prospective payment system for HHAs effective January 1, 2011. T...

Calculating and using the area wage index of the Medicare inpatient hospital Prospective Payment System.

When Congress created the Medicare Prospective Payment System (PPS) for hospitals in 1983, it established separate standardized payment amounts (national average costs per Medicare case) for inpatient services provided by urban and rural hospitals. The urban standardized amount was 25.3 percent greater than the rural standardized amount. This variation in payment was challenged by rural health ...

How Will Elimination of Hospital Bad Debt Reimbursement Affect Rural PPS Hospitals?

In an effort to curtail cross subsidization by other payers, the Medicare program has historically reimbursed hospitals for a portion of bad debt incurred by beneficiaries’ failures to pay deductibles and coinsurance. Since the enactment of the Benefits Improvement and Protection Act of 2000, prospective payment system (PPS) hospitals have been reimbursed 70 percent of bad debt incurred as a re...

The first three years of PPS: impact on Medicare costs.