CMS Issues IPPS Final Rule
On July 31, 2008 the Centers for Medicare and Medicaid Services (CMS) put on display its final rule regarding the Hospital Inpatient Prospective Payment System (IPPS) which includes many of the anticipated Stark final rules effective October 1, 2009.
CMS has proposed many changes in various proposed rules over the past few years and addresses many of the issues for which they have received comment in this final rule. These proposals include burden of proof, per-click leasing arrangements, set-in-advance and percentage-based compensation, stand-in-the shoes provisions, services furnished under arrangements, alternative criteria for satisfying certain exceptions, period of disallowance for noncompliant financial relationships, and more.
CMS says that its goals with this rule are: "minimizing the threat of program and patient abuse while providing sufficient flexibility to enable those who are parties to financial relationships to satisfy the requirements of, and remain in compliance with, the physician self-referral law and the exceptions thereto. Finalizing together the proposals from the CY 2008 PFS and the FY 2009 IPPS proposed rules is consistent with our outlined approach."
CMS acknowledges that they asked for comments on the in-office ancillary loophole last year but do not address this issue in this final rule. Medicare would have to propose changes in the federal register and provide a formal comment period prior to placing any decisions in a final rule. Below is a link to the final rule on IPPS. ACR members interested in reading the self-referral decisions in the rule should turn to page 972.
ACR staff are currently reviewing this section and will post a more detailed summary in the coming days.
Click here to read the IPPS Final rule in its entirety (self-referral section begins on page 972).
