General

General Question for the Week of December 9, 2019

General Compliance Question of the Week

Question:

What are the supposed “other” payment adjustments CMS could subject hospitals to under the 2020 IPPS final rule?

Answer:

CMS specifies that individual hospitals could be subject to other payment adjustments such as:

  • “Penalties for excess readmissions, which reflect an adjustment to a hospital’s performance relative to other hospitals with a similar proportion of patients who are dually eligible for Medicare and full benefit Medicaid
  • Penalty (1 percent) for worst-performing quartile under the Hospital-Acquired Condition Reduction Program
  • Upward and downward adjustments under the Hospital Value-Based Purchasing Program.”