General Question for the Week of December 9, 2019

General Compliance Question of the Week


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


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.”