BNA Quotes Stephanie Webster on Proposed CMS Rule

Bloomberg BNA’s Health Care Daily Report, in its article “Stakeholders Have Mixed Reaction To CMS Quality Provisions in Hospital Rule,” quoted Akin Gump health industry partner Stephanie Webster on the topic of the Centers for Medicare & Medicaid Services’ (CMS) proposed hospital inpatient prospective payment system (IPPS) rule.

Among other changes, the proposal, for which comments are due June 25, changes the Medicare disproportionate share hospital (DSH) adjustment, which compensates hospitals for the costs of treating uninsured patients.

Webster discussed CMS’s methodology for calculating hospitals’ levels of uncompensated care and its significance for hospitals, saying, “What we're seeing from CMS is a surprising mix of the old with the new, a move that seems to be driven by Medicaid policy considerations. Instead of using data on uncompensated care to uninsured patients reported by hospitals…CMS is proposing to use hospital data reflecting services furnished to insured low-income patients…as a proxy for uncompensated care.”

She added, “Depending on the quality and nature of a particular hospital's initial [cost reporting] data , and whether the hospital is located in a state that has expanded Medicaid or not, the agency's data choice could very well impact the hospital's bottom line.”

Webster noted that hospitals will need to comment on this proposed rule in order to add their opinions to the mix: “It is crucial for hospitals to submit comments on the proposed rule because there is a statutory provision that purports to preclude administrative and judicial review of many facets of the agency's implementation of the new DSH proposal (as with other ACA Medicare payment provisions).”