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 2010_register executive 2010-08-16 article Part II Rules and Regulations D09002ee1c8015962 D09002ee1c8015a54 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 of acute care hospitals to implement changes arising from our continuing experience with these systems and to implement certain provisions of the Affordable Care Act and other legislation. In addition, we describe the changes to the amounts and factors used to determine the rates for Medicare acute care hospital inpatient services for operating costs and capital-related costs. We also are setting forth the update to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. We are updating the payment policy and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) and setting forth the changes to the payment rates, factors, and other payment rate policies under the LTCH PPS. In addition, we are finalizing the provisions of the August 27, 2009 interim final rule that implemented statutory provisions relating to payments to LTCHs and LTCH satellite facilities and increases in beds in existing LTCHs and LTCH satellite facilities under the LTCH PPS. We are making changes affecting the: Medicare conditions of participation for hospitals relating to the types of practitioners who may provide rehabilitation services and respiratory care services; and determination of the effective date of provider agreements and supplier approvals under Medicare. We are also setting forth provisions that offer psychiatric hospitals and hospitals with inpatient psychiatric programs increased flexibility in obtaining accreditation to participate in the Medicaid program. Psychiatric hospitals and hospitals with inpatient psychiatric programs will have the choice of undergoing a State survey or of obtaining accreditation from a national accrediting organization whose hospital accreditation program has been approved by CMS. We are also issuing an interim final rule with comment period to implement a provision of the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 relating to Medicare payments for outpatient services provided prior to a Medicare beneficiary's inpatient admission. 75 FR 50042 https://www.govinfo.gov/app/details/FR-2010-08-16/2010-19092 2010-19092 FR16AU10-14 RIN 0938-AP80 RIN 0938-AP33 4120-01-P CMS-1498-Fand CMS-1498-IFC CMS-1406-F https://www.govinfo.gov/app/details/FR-2010-08-16/2010-19092 https://www.govinfo.gov/content/pkg/FR-2010-08-16/html/2010-19092.htm https://www.govinfo.gov/content/pkg/FR-2010-08-16/pdf/2010-19092.pdf Administrative Practice and Procedure Health Facilities Medicare Puerto Rico Reporting and Recordkeeping Requirements Kidney Diseases Health Professions Medicare and Reporting and Recordkeeping Requirements Conditions for Medicare Payment Grant Program-Health Medicaid Family Planning Infants and Children Penalties Prescription Drugs Hospitals Grant Programs-Health 636 p. 50042 50677 75 FR 50042 Title 42 Part 412 42 CFR Part 412 Title 42 Part 413 42 CFR Part 413 Title 42 Part 415 42 CFR Part 415 Title 42 Part 424 42 CFR Part 424 Title 42 Part 440 42 CFR Part 440 Title 42 Part 441 42 CFR Part 441 Title 42 Part 482 42 CFR Part 482 Title 42 Part 485 42 CFR Part 485 Title 42 Part 489 42 CFR Part 489 RIN 0938-AP80 RIN 0938-AP33 Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System Changes and FY2011 Rates; Provider Agreements and Supplier Approvals; and Hospital Conditions of Participation for Rehabilitation and Respiratory Care Services; Medicaid Program: Accreditation for Providers of Inpatient Psychiatric Services; Federal Register Vol. 75, Issue RULE 2010-19092 II DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 2010-10-01 CMS-1498-Fand CMS-1498-IFC CMS-1406-F 4120-01-P 2010-19092 Final rules and interim final rule with comment period.

We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems and to implement certain provisions of the Affordable Care Act and other legislation. In addition, we describe the changes to the amounts and factors used to determine the rates for Medicare acute care hospital inpatient services for operating costs and capital-related costs. We also are setting forth the update to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. We are updating the payment policy and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) and setting forth the changes to the payment rates, factors, and other payment rate policies under the LTCH PPS. In addition, we are finalizing the provisions of the August 27, 2009 interim final rule that implemented statutory provisions relating to payments to LTCHs and LTCH satellite facilities and increases in beds in existing LTCHs and LTCH satellite facilities under the LTCH PPS. We are making changes affecting the: Medicare conditions of participation for hospitals relating to the types of practitioners who may provide rehabilitation services and respiratory care services; and determination of the effective date of provider agreements and supplier approvals under Medicare. We are also setting forth provisions that offer psychiatric hospitals and hospitals with inpatient psychiatric programs increased flexibility in obtaining accreditation to participate in the Medicaid program. Psychiatric hospitals and hospitals with inpatient psychiatric programs will have the choice of undergoing a State survey or of obtaining accreditation from a national accrediting organization whose hospital accreditation program has been approved by CMS. We are also issuing an interim final rule with comment period to implement a provision of the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 relating to Medicare payments for outpatient services provided prior to a Medicare beneficiary's inpatient admission.

Effective Date: These rules are effective on October 1, 2010, except for amendments to Sec. 412.2(c)(5) introductory text, (c)(5)(iii), and (c)(5)(iv); Sec. 412.405; Sec. 412.521(b)(1); Sec. 412.540; Sec. 412.604(f); Sec. 413.40(c)(2) introductory text, (c)(2)(iii), and (c)(2)(iv), that are effective on June 25, 2010 and apply to services furnished on or after June 25, 2010. In accordance with sections 1871(e)(1)(A)(i) and (ii) of the Social Security Act, the Secretary has determined that retroactive application of these regulatory amendments is necessary to comply with the statute and that failure to apply the changes retroactively would be contrary to public interest: Tzvi Hefter, (410) 786-4487, and Ing- Jye Cheng, (410) 786-4548, Operating Prospective Payment, MS-DRGs, Hospital Acquired Conditions (HAC), Wage Index, New Medical Service and Technology Add-On Payments, Hospital Geographic Reclassifications, Acute Care Transfers, Capital Prospective Payment, Excluded Hospitals, Direct and Indirect Graduate Medical Education Payments, Disproportionate Share Hospital (DSH), and Critical Access Hospital (CAH) Issues. Administrative Practice and Procedure Health Facilities Medicare Puerto Rico Reporting and Recordkeeping Requirements Kidney Diseases Health Professions Medicare and Reporting and Recordkeeping Requirements Conditions for Medicare Payment Grant Program-Health Medicaid Family Planning Infants and Children Penalties Prescription Drugs Hospitals Grant Programs-Health Medicare and Medicaid Programs: Changes to the Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals, et al. , //www.RHQDAPU_Registries@cms.hhs.gov CTI@cms.hhs.gov dfp4@cdc.gov Nisha.Bhat@cms.hhs.gov patricia.brooks2@cms.hhs.gov acumenllc.com/reports/cms http://cms.hhs.gov/ICD9ProviderDiagnosticCodes/03_meetings.asp http://cms.hhs.gov/MGCRB/02_instructions_and_applications.asp http://cmsnet.cms.hhs.gov/hpages/oisnew/sysndata/access_to_data/cms-DUA.pdf http://factfinder.census.gov/ http://ssa.gov/online/ss-5.pdf http://www.3MHIS.com http://www.acumenllc.com/reports/cms http://www.cdc.gov/nchs/data/icd9/icdguide09.pdf http://www.cdc.gov/nchs/icd.htm http://www.cdc.gov/nchs/icd/icd9cm_maintenance.htm http://www.cdc.gov/nchs/icd9.htm http://www.cdc.gov/nhsn/ http://www.census.gov/popest/estimates.html http://www.cms.gov http://www.cms.gov/AcuteInpatientPPS/IPPS2010/itemdetail.asp?filterType=none&filterByDID=-99&sortByDID=1&sortOrder=ascending&itemID=CMS1235590&intNumPerPage=10 http://www.cms.gov/AcuteInpatientPPS/IPPS2011/list.asp#TopOfPage http://www.cms.gov/ICD10/17_ICD10_MS_DRG_Conversion_Project.asp http://www.cms.gov/ICD9ProviderDiagnosticCodes/03_meetings.asp http://www.cms.gov/LimitedDataSets/12_StandardAnalyticalFiles.asp http://www.cms.gov/MedicareAdvtgSpecRateStats/Downloads/Announcement2010.pdf http://www.cms.gov/PrivProtectedData/07_DSHRateData.asp 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 http://www.cms.hhs.gov/AcuteInpatientPPS/10FR/ http://www.cms.hhs.gov/AcuteInpatientPPS/: http://www.cms.hhs.gov/AcuteInpatientPPS/downloads/HospitalVBPPlanRTCFINALSUBMITTED2007.pdf http://www.cms.hhs.gov/AcuteInpatientPPS/IPPS2009 http://www.cms.hhs.gov/AcuteInpatientPPS/IPPS2009/ http://www.cms.hhs.gov/AcuteInpatientPPS/WIFN/itemdetail.asp?filterType=none&filterByDID=0&sortByDID=3&sortOrder=descending&itemID=CMS1231035&intNumPerPage=10 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/CouncilonTechInnov/Downloads/InnovatorsGuide8_25_08.pdf http://www.cms.hhs.gov/HospitalAcqCond http://www.cms.hhs.gov/HospitalAcqCond/ http://www.cms.hhs.gov/HospitalQualityInits/ http://www.cms.hhs.gov/HospitalQualityInits/15_HospitalInpatientEHRTesting.asp 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http://www.qualityforum.org/Measuring_Performance/Consensus_Development_Process.aspx http://www.qualityforum.org/Projects/a-b/Ad_Hoc_Reviews/Statin_Medication/Ad_Hoc_Review__Discharged_on_Statin.aspx http://www.qualityindicators.ahrq.gov/downloads/publications/AHRQ%20QI%20Guide%20to%20Comparative%20Reporting%20v10.pdf http://www.qualityindicators.ahrq.gov/TechnicalSpecs41.htm#PSI41 http://www.QualityNet.org http://www.QualityNet.org/ http://www.rand.org/pubs/working_papers/WR560/ http://www.regulations.gov http://www.RHQDAPU_Registries http://www.rti.org/reports/cms http://www.rti.org/reports/cms/ 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/contractingopportunities/officials/table/index.html http://www.theabr.org/ic/ic_vir/ic_vir_direct.html http://www.theabr.org/ic/ic_vir/ic_vir_req.html http://www.whitehouse.gov/OMB http://www.whitehouse.gov/omb/circulars/a004/a-4.pdf https://www.QualityNet.org/ swais.access.gpo.gov Vol. 75, no. 157 Office of the Federal Register, National Archives and Records Administration 2010-08-16 continuing daily deposited born digital 882 p. Table of Contents: AE 2.7: GS 4.107: AE 2.106: KF70.A2 https://www.govinfo.gov/app/details/FR-2010-08-16 P0b002ee1803aa505 0097-6326 0042-1219 0364-1406 769-004-00000-9 000582072 f:FR16AU10 https://www.govinfo.gov/app/details/FR-2010-08-16 https://www.govinfo.gov/content/pkg/FR-2010-08-16/pdf/FR-2010-08-16.pdf https://www.govinfo.gov/content/pkg/FR-2010-08-16/xml/FR-2010-08-16.xml fdlp 49813 50681 DGPO 2010-08-16 2024-06-04 FR-2010-08-16 machine generated eng FR FR-2010-08-16 75 157