United States Government Publishing Office publisher pbl distributor dst United States National Archives and Records Administration Office of the Federal Register author aut Government Organization text government publication eng FR Regulatory Information 2004_register executive 2012-11-05 article Part II Rules and Regulations D09002ee1c8147817 D09002ee1c81479e4 United States Department of Health and Human Services originator org United States Government Agency or Subagency United States Centers for Medicare & Medicaid Services originator org United States Government Agency or Subagency United States Department of Agriculture originator org United States Government Agency or Subagency United States Commodity Credit Corporation originator org United States Government Agency or Subagency We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs to implement changes arising from our continuing experience with these systems; and to implement a number of changes made by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 that was enacted on December 8, 2003. In addition, in the Addendum to this final rule, we describe the changes to the amounts and factors used to determine the rates for Medicare hospital inpatient services for operating costs and capital-related costs. These changes are applicable to discharges occurring on or after October 1, 2004. We also are setting forth rate-of-increase limits as well as policy changes for hospitals and hospital units excluded from the IPPS that are paid in full or in part on a reasonable cost basis subject to these limits. Among the policy changes that we are making are: Changes to the classification of cases to the diagnosis-related groups (DRGs); changes to the long-term care (LTC)-DRGs and relative weights; changes in the wage data, labor-related share of the wage index, and the geographic area designations used to compute the wage index; changes in the qualifying threshold criteria for and the approval of new technologies and medical services for add-on payments; changes to the policies governing postacute care transfers; changes to payments to hospitals for the direct and indirect costs of graduate medical education; changes to the payment adjustment for disproportionate share rural hospitals; changes in requirements and payments to critical access hospitals (CAHs); changes to the disclosure of information requirements for Quality Improvement Organization (QIOs); and changes in the hospital conditions of participation for discharge planning and fire safety requirements for certain health care facilities. 69 FR 48916 https://www.govinfo.gov/app/details/FR-2004-08-11/04-17943 04-17943 fr11au04-15 RIN 0938-AM80 RIN 0560-AH08 4121-01-C CMS-1428-F https://www.govinfo.gov/app/details/FR-2004-08-11/04-17943 https://www.govinfo.gov/content/pkg/FR-2004-08-11/html/04-17943.htm https://www.govinfo.gov/content/pkg/FR-2004-08-11/pdf/04-17943.pdf Health Insurance Hospitals Incorporation by Reference Intergovernmental Relations Medicare Reporting and Recordkeeping Requirements Administrative Practice and Procedure Health Facilities Puerto Rico Kidney Diseases Hospice Care Aged Health Care Medicaid Health Records Peer Review Organizations (Pro) Penalties Privacy Grant Programs-Health Health Professions Nursing Homes Nutrition Safety 866 p. 48916 49781 69 FR 48916 Title 42 Part 403 42 CFR Part 403 Title 42 Part 412 42 CFR Part 412 Title 42 Part 413 42 CFR Part 413 Title 42 Part 418 42 CFR Part 418 Title 42 Part 460 42 CFR Part 460 Title 42 Part 480 42 CFR Part 480 Title 42 Part 482 42 CFR Part 482 Title 42 Part 483 42 CFR Part 483 Title 42 Part 485 42 CFR Part 485 Title 42 Part 489 42 CFR Part 489 RIN 0938-AM80 RIN 0560-AH08 Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2005 Rates; Federal Register Vol. 69, Issue RULE 04-17943 II DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services DEPARTMENT OF AGRICULTURE Commodity Credit Corporation 2004-10-01 CMS-1428-F 4121-01-C 04-17943 Final rule.

We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs to implement changes arising from our continuing experience with these systems; and to implement a number of changes made by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 that was enacted on December 8, 2003. In addition, in the Addendum to this final rule, we describe the changes to the amounts and factors used to determine the rates for Medicare hospital inpatient services for operating costs and capital-related costs. These changes are applicable to discharges occurring on or after October 1, 2004. We also are setting forth rate-of-increase limits as well as policy changes for hospitals and hospital units excluded from the IPPS that are paid in full or in part on a reasonable cost basis subject to these limits. Among the policy changes that we are making are: Changes to the classification of cases to the diagnosis-related groups (DRGs); changes to the long-term care (LTC)-DRGs and relative weights; changes in the wage data, labor-related share of the wage index, and the geographic area designations used to compute the wage index; changes in the qualifying threshold criteria for and the approval of new technologies and medical services for add-on payments; changes to the policies governing postacute care transfers; changes to payments to hospitals for the direct and indirect costs of graduate medical education; changes to the payment adjustment for disproportionate share rural hospitals; changes in requirements and payments to critical access hospitals (CAHs); changes to the disclosure of information requirements for Quality Improvement Organization (QIOs); and changes in the hospital conditions of participation for discharge planning and fire safety requirements for certain health care facilities.

The provisions of this final rule are effective on October 1, 2004. Jim Hart, (410) 786-9520, Operating Prospective Payment, Diagnosis- Related Groups (DRGs), Wage Index, New Medical Services and Technology, Standardized Amounts, Hospital Geographic Reclassifications, Postacute Care Transfers, and Disproportionate Share Hospital Issuesp; Tzvi Hefter, (410) 786-4487, Capital Prospective Payment, Excluded Hospitals, Graduate Medical Education, Critical Access Hospitals, and Long-Term Care (LTC)-DRGs Issues; Health Insurance Hospitals Incorporation by Reference Intergovernmental Relations Medicare Reporting and Recordkeeping Requirements Administrative Practice and Procedure Health Facilities Puerto Rico Kidney Diseases Hospice Care Aged Health Care Medicaid Health Records Peer Review Organizations (Pro) Penalties Privacy Grant Programs-Health Health Professions Nursing Homes Nutrition Safety Medicare: Hospital inpatient prospective payment systems and FY 2005 rates, barbara.fecso@usda.gov dfp4@cdc.gov Patricia.Brooks1@cms.hhs.gov hhs.gov/providers/hipps/ippswage.asp http://belize.hrsa.gov/newhpsa/newhpsa.cfm http://bhpr.hrsa.gov/diversity/coe/grantees2003.htm http://cms.hhs.gov/providers/hipps/ippswage.asp http://cms.hhs.gov/providers/prrb/mgcinfo.asp http://www.access.gpo.gov/nara_docs/ http://www.ama-assn.org/ama/pub/category/7952.html http://www.archives.gov/federal_register/code_of_federal_regulations/ibr_locations.html http://www.bls.gov/oes/2001/oes_tec.htm http://www.bls.gov/oes/2001/oesi3_806.htm http://www.cdc.gov/nchs/icd9.htm http://www.census.gov/population/www/estimates/metrodef.html http://www.cms.gov http://www.cms.gov/manuals/pm_trans/r2ncd1.pdf http://www.cms.gov/paymentsystems/icd9/ http://www.cms.hhs.gov http://www.cms.hhs.gov/data/order/default.asp http://www.cms.hhs.gov/forms/ http://www.cms.hhs.gov/medlearn/icd9code.asp http://www.cms.hhs.gov/paymentsystems/icd9 http://www.cms.hhs.gov/paymentsystems/icd9/ http://www.cms.hhs.gov/providers/hipps/default.asp http://www.cms.hhs.gov/providers/hipps/dual.asp http://www.cms.hhs.gov/providers/hipps/newtech.asp http://www.cms.hhs.gov/providers/hipps/resident.asp http://www.cms.hhs.gov/quality/hospital http://www.cms.hhs.gov/researchers/demos/rch.asp http://www.hcfa.gov/stats/pufiles.htm http://www.medicare.gov http://www.medpac.gov http://www.osha.gov/SLTC/bloodbornepathogens/ http://www.qnetexchange.org http://www.whitehouse.gov/omb/bulletins/fy04/b04-03.html swais.access.gpo.gov www.cms.hhs.gov www.cms.hhs.gov/providers/hipps/ippswage.asp www.medicare.gov Vol. 69, no. 154 Office of the Federal Register, National Archives and Records Administration 2004-08-11 continuing daily deposited born digital 1028 p. Table of Contents: AE 2.7: GS 4.107: AE 2.106: KF70.A2 https://www.govinfo.gov/app/details/FR-2004-08-11 P0b002ee18376d884 0097-6326 0042-1219 0364-1406 769-004-00000-9 000582072 f:fr11au04 https://www.govinfo.gov/app/details/FR-2004-08-11 https://www.govinfo.gov/content/pkg/FR-2004-08-11/pdf/FR-2004-08-11.pdf https://www.govinfo.gov/content/pkg/FR-2004-08-11/xml/FR-2004-08-11.xml fdlp 48765 49781 DGPO 2012-11-05 2024-06-06 FR-2004-08-11 machine generated eng FR FR-2004-08-11 69 154