On Tuesday, the Centers for Medicare & Medicaid Services (CMS) released the fiscal year (FY) 2024 Medicare Hospital Inpatient Prospective Payment System (IPPS) and the long-term care hospital (LTCH) prospective payment system
final rule.
The rule increases operating payment rates by 3.1% for general acute care hospitals that are paid under the IPPS, successfully participate in the Hospital Inpatient Quality Reporting Program, and are meaningful electronic health record users. This increase reflects a projected FY 2024 IPPS hospital market basket update of 3.3%, reduced by a statutorily required 0.2% productivity adjustment.
A representative of the American Hospital Association offered a stinging response to the payment increase that was worthy enough to feature in our
Heard on the Street.
FY 2024 applications for new technology add-on payments (NTAPs) (traditional pathway)
CMS finalized its policy in the FY 2023 IPPS/LTCH PPS final rule to publicly post online applications for NTAP beginning with FY 2024 applications. As a result, the agency is providing more succinct information as part of the summaries in the proposed and final rules regarding the applicant’s assertions as to how the medical service or technology meets the newness, cost, and substantial clinical improvement criteria. Readers may click
here for the publicly posted FY 2024 NTAP applications and supporting information.
CMS received 27 applications for NTAPs for FY 2024 under the traditional NTAP pathway. The status of those 27 applications is as follows:
A discussion of the 13 approved and unapproved applications begins on page 415 of the
public inspection version.
Changes to NTAP policies for FY 2024
To increase transparency and improve the efficiency of the NTAP program and application process, CMS is finalizing its proposal to:
CMS believes these policy changes will enforce NTAP applications being completed on time, improve CMS’ ability to analyze the applications more fully, and allow the public to better analyze applications.
Changes to the new COVID-19 treatments add-on payment (NCTAP)
In response to the COVID-19 public health emergency (PHE), CMS established the NCTAP for eligible discharges during the PHE. In the FY 2022 IPPS/LTCH PPS final rule, the agency extended NCTAP through the end of the FY in which the PHE ends, for all eligible products, to continue to mitigate potential financial disincentives for hospitals to provide these new treatments, and to minimize any potential payment disruption immediately following the end of the PHE. CMS noted that, as the PHE ended on May 11, 2023, discharges involving eligible products will continue to be eligible for the NCTAP through September 30, 2023 (ie, through the end of FY 2023). The NCTAP will expire at the end of FY 2023, and no NCTAP will be made beginning in FY 2024 (ie, for discharges on or after October 1, 2023).
Social Determinants of Health (SDOH) diagnosis codes
As SDOH diagnosis codes are increasingly added to billed claims, CMS announced it will continue to analyze the effects of SDOH on severity of illness, complexity of services, and consumption of resources.
The IPPS/LTC final rule is scheduled to be published in the upcoming August 28 issue of the
Federal Register. It will go into effect October 1, 2023. The final rule was accompanied by a
press release and
fact sheet.
If you have questions about the NTAP process or the SDOH diagnosis codes, please contact
Corey Ford.
