The 2013 Inpatient Prospective Payment System Proposed Rule, issued by the Centers for
Medicare & Medicaid Services (CMS) on May 11, 2012, proposes
some important changes relating to graduate medical education (GME)
reimbursement for teaching hospitals. Comments regarding the
Proposed Rule are due June 25, 2012.
The GME-related changes in the Proposed Rule include:
Increasing the period of time, from three years to five, in
which a new teaching hospital can establish its full-time
equivalent (FTE) cap and changing the calculations of new
hospitals' direct GME and indirect GME (IME) caps when
residents rotate to more than one hospital during the cap-building
Creating additional requirements in order for hospitals that
received additional slots from hospitals that had their caps
reduced to keep those slots;
Changing the ranking criteria for hospitals applying for cap
space from hospitals that closed, as well as the effective dates of
the transferred slots; and
Including labor and delivery beds in the calculation of the
hospital's IME adjustment.
Teaching hospitals should review and closely analyze each of the
proposed changes to determine whether they achieve the best result
for the hospital's Medicare GME reimbursement needs.
The content of this article is intended to provide a general
guide to the subject matter. Specialist advice should be sought
about your specific circumstances.
To print this article, all you need is to be registered on Mondaq.com.
Click to Login as an existing user or Register so you can print this article.
Whether you are an employer that provides health insurance for your employees, a business in the growing healthcare industry, a hospital, or other medical provider—or you provide services to any of those entities—you need to know about changes to the privacy and security rules under the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
Marilyn Tavenner received bipartisan support from members of the Senate Committee on Finance in her confirmation hearing to lead the Centers for Medicare and Medicaid Services (CMS) though a full Senate vote is being held up, the president released his FY 2014 budget proposal with health care reform and specified reimbursement reductions to providers and manufacturers totaling $400 billion over 10 years sprinkled throughout it, and Department of Health and Human Services (HHS) Secretary Sebelius
The Office of Inspector General for the Department of Health and Human Services has recently issued an updated Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs.
On Tuesday, the North Carolina legislature has enacted into law, pending the governor's signature, a prohibition on the use of most favored nations clauses in contracts between commercial health insurers and providers.