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
2008_register
executive
2010-09-23
article
Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2009 Rates; Payments for Graduate Medical Education in Certain Emergency Situations; Changes to Disclosure of Physician Ownership in Hospitals and Physician Self-Referral Rules; Updates to the Long-Term Care Prospective Payment System; Updates to Certain IPPS-Excluded Hospitals; and Collection of Information Regarding Financial Relationships Between Hospitals
Part II
Rules and Regulations
D09002ee1bdd88bd2
D09002ee1bdd88c70
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
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 certain provisions made by the Deficit Reduction Act of 2005, the Medicare Improvements and Extension Act, Division B, Title I of the Tax Relief and Health Care Act of 2006, the TMA, Abstinence Education, and QI Programs Extension Act of 2007, and the Medicare Improvements for Patients and Providers Act of 2008. 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 generally applicable to discharges occurring on or after October 1, 2008. We also are setting forth the update to the rate-of-increase limits for certain hospitals and hospital units excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. The updated rate-of-increase limits are effective for cost reporting periods beginning on or after October 1, 2008. In addition to the changes for hospitals paid under the IPPS, this document contains revisions to the patient classifications and relative weights used under the long-term care hospital prospective payment system (LTCH PPS). This document also contains policy changes relating to the requirements for furnishing hospital emergency services under the Emergency Medical Treatment and Labor Act of 1986 (EMTALA). In this document, we are responding to public comments and finalizing the policies contained in two interim final rules relating to payments for Medicare graduate medical education to affiliated teaching hospitals in certain emergency situations. We are revising the regulatory requirements relating to disclosure to patients of physician ownership or investment interests in hospitals and responding to public comments on a collection of information regarding financial relationships between hospitals and physicians. In addition, we are responding to public comments on proposals made in two separate rulemakings related to policies on physician self-referrals and finalizing these policies.
73 FR 48434
https://www.govinfo.gov/app/details/FR-2008-08-19/E8-17914
E8-17914
fr19au08-13
RIN 0938-AP15
RIN 0938-AO35
RIN 0938-AO65
4120-01-P
CMS-1390-F
CMS-1531-IFC1
CMS-1531-IFC2
CMS-1385-F4
https://www.govinfo.gov/app/details/FR-2008-08-19/E8-17914
https://www.govinfo.gov/content/pkg/FR-2008-08-19/html/E8-17914.htm
https://www.govinfo.gov/content/pkg/FR-2008-08-19/pdf/E8-17914.pdf
Kidney Diseases
Medicare
Physician Referral
Reporting and Recordkeeping Requirements
Administrative Practice and Procedure
Health Facilities
Puerto Rico
Grant Programs-Health
Health Care
Health Insurance
Health Maintenance Organizations (Hmo)
Loan Programs-Health
650 p.
48434
49083
73 FR 48434
Code of Federal Regulations
Title 42 Part 411
42 CFR Part 411
Code of Federal Regulations
Title 42 Part 412
42 CFR Part 412
Code of Federal Regulations
Title 42 Part 413
42 CFR Part 413
Code of Federal Regulations
Title 42 Part 422
42 CFR Part 422
Code of Federal Regulations
Title 42 Part 489
42 CFR Part 489
Regulation Identification Number 0938-AP15
RIN 0938-AP15
Regulation Identification Number 0938-AO35
RIN 0938-AO35
Regulation Identification Number 0938-AO65
RIN 0938-AO65
Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2009 Rates; Payments for Graduate Medical Education in Certain Emergency Situations; Changes to Disclosure of Physician Ownership in Hospitals and Physician Self-Referral Rules; Updates to the Long-Term Care Prospective Payment System; Updates to Certain IPPS-Excluded Hospitals; and Collection of Information Regarding Financial Relationships Between Hospitals; Federal Register Vol. 73, Issue
RULE
E8-17914
II
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
2008-10-01
CMS-1390-F
CMS-1531-IFC1
CMS-1531-IFC2
CMS-1385-F4
4120-01-P
E8-17914
Final rules.
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 certain provisions made by the Deficit Reduction Act of 2005, the Medicare Improvements and Extension Act, Division B, Title I of the Tax Relief and Health Care Act of 2006, the TMA, Abstinence Education, and QI Programs Extension Act of 2007, and the Medicare Improvements for Patients and Providers Act of 2008. 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 generally applicable to discharges occurring on or after October 1, 2008. We also are setting forth the update to the rate-of-increase limits for certain hospitals and hospital units excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. The updated rate-of-increase limits are effective for cost reporting periods beginning on or after October 1, 2008. In addition to the changes for hospitals paid under the IPPS, this document contains revisions to the patient classifications and relative weights used under the long-term care hospital prospective payment system (LTCH PPS). This document also contains policy changes relating to the requirements for furnishing hospital emergency services under the Emergency Medical Treatment and Labor Act of 1986 (EMTALA). In this document, we are responding to public comments and finalizing the policies contained in two interim final rules relating to payments for Medicare graduate medical education to affiliated teaching hospitals in certain emergency situations. We are revising the regulatory requirements relating to disclosure to patients of physician ownership or investment interests in hospitals and responding to public comments on a collection of information regarding financial relationships between hospitals and physicians. In addition, we are responding to public comments on proposals made in two separate rulemakings related to policies on physician self-referrals and finalizing these policies.
Effective Dates: This final rule is effective on October 1, 2008, with the following exceptions: Amendments to Sec. Sec. 412.230, 412.232, and 412.234 are effective on September 2, 2008. Amendments to Sec. Sec. 411.357(a)(5)(ii), (b)(4)(ii), (1)(3)(i) and (ii), and (p)(1)(i)(A) and (B) and the definition of entity in Sec. 411.351 are effective on October 1, 2009.
Gay Burton, (410) 786-4487, Operating Prospective Payment, MS-DRGs, Wage Index, New Medical Service and Technology Add-On Payments, Hospital Geographic Reclassifications, and Postacute Care Transfer Issues.
Kidney Diseases
Medicare
Physician Referral
Reporting and Recordkeeping Requirements
Administrative Practice and Procedure
Health Facilities
Puerto Rico
Grant Programs-Health
Health Care
Health Insurance
Health Maintenance Organizations (Hmo)
Loan Programs-Health
Medicare Program:
Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2009 Rates; Payments for Graduate Medical Education in Certain Emergency Situations,
CTI@cms.hhs.gov
dfp4@cdc.gov
patricia.brooks2@cms.hhs.gov
http://cms.hhs.gov/ICD9ProviderDiagnosticCodes/03_meetings.asp
http://cms.hhs.gov/providers/prrb/mgcinfo.asp
http://oig.hhs.gov/oas/cms.html
http://orthoinfo.aaos.org/topic.cfm?topic=A00219
http://www.acumenllc.com/reports/cms
http://www.ahrq.gov/clinic/ptsafety/chap28.htm
http://www.ahrq.gov/clinic/ptsafety/pdf/ptsafety.pdf
http://www.ahrq.gov/qual/nqfpract.htm
http://www.cdc.gov/handhygiene/
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4908a1.htm
http://www.cdc.gov/nchs/about/otheract/icd9/maint/maint.htm
http://www.cdc.gov/nchs/datawh/ftpserv/ftpICD9/ftpICD9.htm
http://www.cdc.gov/nchs/datawh/ftpserv/ftpicd9/icdguide07.pdf
http://www.cdc.gov/nchs/icd9.htm
http://www.cdc.gov/nchs/products/_prods/subject/icd96ed.htm
http://www.cdc.gov/ncidod/dbmd/diseaseinfo/legionellosis_g.htm
http://www.cdc.gov/ncidod/dhqp/ar_mrsa.html
http://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca_public.html
http://www.cdc.gov/ncidod/dhqp/gl_catheter_assoc.html
http://www.cdc.gov/ncidod/dhqp/gl_intravascular.html
http://www.cdc.gov/ncidod/dhqp/gl_isolation.html
http://www.cdc.gov/ncidod/dhqp/gl_surgicalsite.html
http://www.cdc.gov/ncidod/dhqp/id_CdiffFAQ_HCP.html#9
http://www.cdc.gov/od/oc/media/pressrel/r2k0306b.htm
http://www.chestjournal.org/cgi/reprint/126/3_suppl/172S
http://www.cms.hhs.gov
http://www.cms.hhs.gov/AcuteInpatientPPS
http://www.cms.hhs.gov/AcuteInpatientPPS/
http://www.cms.hhs.gov/AcuteInpatientPPS/01_overview.asp
http://www.cms.hhs.gov/AcuteInpatientPPS/04_outlier.asp#TopOfPage
http://www.cms.hhs.gov/AcuteInpatientPPS/08_newtech.asp#TopOfPage
http://www.cms.hhs.gov/AcuteInpatientPPS/:
http://www.cms.hhs.gov/AcuteInpatientPPS/downloads/hospital_VBP_plan_issues_paper.pdf
http://www.cms.hhs.gov/AcuteInpatientPPS/downloads/HospitalVBPPlanRTCFINALSUBMITTED2007.pdf
http://www.cms.hhs.gov/AcuteInpatientPPS/WIFN/list.asp#TopOfPage
http://www.cms.hhs.gov/center/hospital.asp
http://www.cms.hhs.gov/CouncilonTechInnov/
http://www.cms.hhs.gov/FACA/07_emtalatag.asp
http://www.cms.hhs.gov/HospitalAcqCond
http://www.cms.hhs.gov/HospitalAcqCond/07_EducationalResources.asp
http://www.cms.hhs.gov/icd9ProviderDiagnosticCodes/01_overview.asp#TopofPage
http://www.cms.hhs.gov/manuals/downloads/clm104c03.pdf
http://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id=211
http://www.cms.hhs.gov/mcd/viewdraftdecisionmemo.asp?from2=viewdraftdecisionmemo.asp&id=211&
http://www.cms.hhs.gov/mcd/viewdraftdecisionmemo.asp?id=211
http://www.cms.hhs.gov/OpenDoorForums/
http://www.cms.hhs.gov/OpendoorForums/05_ODF_SpecialODF.asp
http://www.cms.hhs.gov/PaperworkReductionActof1995/PRAL/list.asp#TopOfPage
http://www.cms.hhs.gov/PhysicianSelfReferral/06a_DRA_Reports.asp
http://www.cms.hhs.gov/providers/hipps
http://www.cms.hhs.gov/SurveyCertificationGenInfo/PMSR/list.asp
http://www.cms.hhs.gov/Transmittals/downloads/R1233CP.pdf
http://www.gpoaccess.gov/
http://www.guideline.gov/browse/guideline_index.aspx
http://www.hcahpsonline.org
http://www.hcahpsonline.org/modeadjustment.aspx
http://www.hhs.gov/budget/09budget/2009BudgetInBrief.pdf
http://www.hospitalcompare.hhs.gov
http://www.iom.edu/CMS/3809/19805/31310.aspx
http://www.iom.edu/Object.File/Master/4/117/ToErr-8pager.pdf
http://www.leapfroggroup.org/media/file/Leapfrog_hospital_acquired_infections_release.pdf
http://www.legionella.org/
http://www.medpac.gov
http://www.medpac.gov/documents/Jun07_EntireReport.pdf
http://www.medpac/publications/congressional_Reports/Mar05_TOC.pdf
http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat2.chapter.4409
http://www.ncbi.nlm.nih.gov/pubmed/1485006
http://www.QualityNet.org
http://www.QualityNet.org/dcs/ContentServer?cid=1163010398556&pagename=QnetPublic%2FPage%2FQnetTier2&c=Page
http://www.rcjournal.com/cpgs/09.03.0869.html
http://www.rti.org/reports/cms/HHSM-500-2005-0029I/PDF/Refining_Cost_to_Charge_Ratios_200804.pdf
http://www.rti.org/reports/cms/HHSM-500-2005-0029I/PDF/Refining_Cost_to_Charge_Ratios_200807_Final.pdf
http://www.sba.gov/services/contractingopportunities/sizestandardstopics/tableofsize/index.html
http://www.whitehousegov/omb/circulars/a004/a-4.pdf
https://www.whitehouse.gov/OMB
swais.access.gpo.gov
www.cms.hhs.gov/AcuteInpatientPPS
www.regulations.gov
Federal Register
Vol. 73, no. 161
Office of the Federal Register, National Archives and Records Administration
2008-08-19
continuing
daily
deposited
born digital
815 p.
Table of Contents:
AE 2.7:
GS 4.107:
AE 2.106:
KF70.A2
https://www.govinfo.gov/app/details/FR-2008-08-19
P0b002ee1809c4228
0097-6326
0042-1219
0364-1406
769-004-00000-9
000582072
f:fr19au08
https://www.govinfo.gov/app/details/FR-2008-08-19
https://www.govinfo.gov/content/pkg/FR-2008-08-19/pdf/FR-2008-08-19.pdf
https://www.govinfo.gov/content/pkg/FR-2008-08-19/xml/FR-2008-08-19.xml
fdlp
48279
49083
DGPO
2010-09-23
2023-05-02
FR-2008-08-19
machine generated
eng
FR
FR-2008-08-19
73
161