Federal Register. Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long- Term Care Hospital Prospective Payment System and Proposed Fiscal Year 2. Rates; Quality Reporting Requirements for Specific Providers; Reasonable Compensation Equivalents for Physician Services in Excluded Teaching Hospitals; Provider Administrative Appeals and Judicial Review; Enforcement Provisions for Organ Transplant Centers; and Electronic Health Record (EHR) Incentive Program. This proposed rule would revise the Medicare hospital outpatient prospective payment system (OPPS). Hospital Value-Based Purchasing (VBP) Program. Facility Value-Based Purchasing (SNF VBP) Program beginning with FY 2019 under which value-based incentive. Nursing Facilities Proposed Rule for FY 2017, SNF Value-Based Purchasing Program, SNF. Skilled Nursing Facility Value-Based Purchasing Program (SNF VBP). FY 2016 Inpatient PPS Proposed Rule – Quality Issues. FY 2016 IPPS Proposed Rule Key. Value Based Purchasing Program. HEALTH PAYMENT RATES, VALUE-BASED PURCHASING PILOT. Health Industry Washington Watch. Regulations CMS Proposes Hospital Value Based Purchasing Program. Hospital Inpatient Quality Reporting and Hospital Value-Based Purchasing—Program. The LTCH PPS tables for this FY 2015 proposed rule are available. The CMS has responded to calls to eliminate patient satisfaction on pain management from the value-based purchasing program. Start Preamble. Start Printed Page 2. AGENCY: Centers for Medicare and Medicaid Services (CMS), HHS. ACTION: Proposed rule. SUMMARY: We are proposing to revise the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital- related costs of acute care hospitals to implement changes arising from our continuing experience with these systems. Some of the proposed changes implement certain statutory provisions contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2. Affordable Care Act), the Protecting Access to Medicare Act of 2. These proposed changes would be applicable to discharges occurring on or after October 1, 2. We also are proposing to update the rate- of- increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. The proposed updated rate- of- increase limits would be effective for cost reporting periods beginning on or after October 1, 2. Department of Health and Human Services. SNF Value-Based Purchasing Program. Proposed Rule for FY 2017, SNF Value- Based Purchasing Program. FY2015 Proposed Hospital Inpatient Rule. Proposed changes to the Hospital Value-based Purchasing Program. We also are proposing to update the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long- term care hospitals (LTCHs) and to implement certain statutory changes to the LTCH PPS under the Affordable Care Act and the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2. Protecting Access to Medicare Act of 2. In addition we are proposing to revise the interruption of stay policy for LTCHs and to retire the “5 percent” payment adjustment for co- located LTCHs. While many of the statutory mandates of the Pathway for SGR Reform Act will apply to discharges occurring on or after October 1, 2. However, in light of the degree of forthcoming change, we discuss changes infra and request public feedback to inform our proposals for FY 2. In addition, we are proposing to make a number of changes relating to direct graduate medical education (GME) and indirect medical education (IME) payments. We are proposing to establish new requirements or revise requirements for quality reporting by specific providers (acute care hospitals, PPS- exempt cancer hospitals, and LTCHs) that are participating in Medicare. We are proposing to update policies relating to the Hospital Value- Based Purchasing (VBP) Program, the Hospital Readmissions Reduction Program, and the Hospital- Acquired Condition (HAC) Reduction Program. In addition, we are proposing changes to the regulations governing provider administrative appeals and judicial review relating to appropriate claims in provider cost reports; updates to the reasonable compensation equivalent (RCE) limits for services furnished by physicians to teaching hospitals excluded from the IPPS; regulatory revisions to broaden the specified uses of risk adjustment data and to specify the conditions for release of risk adjustment data to entities outside of CMS; and changes to the enforcement procedures for organ transplant centers. We are proposing to align the reporting and submission timelines for clinical quality measures for the Medicare EHR Incentive Program for eligible hospitals and critical access hospitals (CAHs) with the reporting and submission timelines for the Hospital IQR Program. In addition, we provide guidance and clarification of certain policies for eligible hospitals and CAHs such as our policy for reporting zero denominators on clinical quality measures and our policy for case threshold exemptions. DATES: Comment Period: To be assured consideration, comments must be received at one of the addresses provided below, no later than 5 p. EDT on June 3. 0, 2. ADDRESSES: In commenting, please refer to file code CMS- 1. P. Because of staff and resource limitations, we cannot accept comments by facsimile (FAX) transmission. You may submit comments in one of four ways (no duplicates, please): 1. You may (and we encourage you to) submit electronic comments on this regulation to http: //www. Follow the instructions under the “submit a comment” tab. You may mail written comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS- 1. P, P. O. Box 8. 01. Baltimore, MD 2. 12. Please allow sufficient time for mailed comments to be received before the close of the comment period. By express or overnight mail. You may send written comments via express or overnight mail to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS- 1. P, Mail Stop C4- 2. Security Boulevard, Baltimore, MD 2. If you prefer, you may deliver (by hand or courier) your written comments before the close of the comment period to either of the following addresses: a. For delivery in Washington, DC—Centers for Medicare & Medicaid Services, Department of Health and Human Services, Room 4. G, Hubert H. Humphrey Building, 2. Independence Avenue SW., Washington, DC 2. Because access to the interior of the Hubert H. Humphrey Building is not readily available to persons without Federal Government identification, commenters are encouraged to leave their comments in the CMS drop slots located in the main lobby of the building. A stamp- in clock is available for persons wishing to retain a proof of filing by stamping in and retaining an extra copy of the comments being filed.)b. For delivery in Baltimore, MD—Centers for Medicare & Medicaid Services, Department of Health and Human Services, 7. Security Boulevard, Baltimore, MD 2. If you intend to deliver your comments to the Baltimore address, please call the telephone number (4. Comments mailed to the addresses indicated as appropriate for hand or courier delivery may be delayed and received after the comment period. For information on viewing public comments, we refer readers to the Start Printed Page 2. SUPPLEMENTARY INFORMATION section. Start Further Info. FOR FURTHER INFORMATION CONTACT: Donald Thompson, (4. Tiffany Swygert, (4. Operating Prospective Payment, MS- DRGs, Hospital- Acquired Conditions (HAC), Wage Index, New Medical Service and Technology Add- On Payments, Hospital Geographic Reclassifications, Graduate Medical Education, Capital Prospective Payment, Excluded Hospitals, and Medicare Disproportionate Share Hospital (DSH) Issues. Michele Hudson, (4. Judith Richter, (4. Long- Term Care Hospital Prospective Payment System and MS- LTC- DRG Relative Weights Issues. Siddhartha Mazumdar, (4. Rural Community Hospital Demonstration Program Issues. James Poyer, (4. 10) 7. Hospital Inpatient Quality Reporting and Hospital Value- Based Purchasing—Program Administration, Validation, and Reconsideration Issues. Karen Nakano, (4. Hospital Inpatient Quality Reporting—Measures Issues Except Hospital Consumer Assessment of Healthcare Providers and Systems Issues; and Readmission Measures for Hospitals Issues. Elizabeth Goldstein, (4. Hospital Inpatient Quality Reporting—Hospital Consumer Assessment of Healthcare Providers and Systems Measures Issues. Mary Pratt, (4. 10) 7. LTCH Quality Data Reporting Issues. Kim Spalding Bush, (4. Hospital Value- Based Purchasing Efficiency Measures Issues. James Poyer, (4. 10) 7. PPS- Exempt Cancer Hospital Quality Reporting Issues. Kellie Shannon, (4. Appropriate Claims in Provider Cost Reports; Administrative Appeals by Providers and Judicial Review Issues. Amelia Citerone, (4. Robert Kuhl (4. 10) 7. Reasonable Compensation Equivalent (RCE) Limits for Physician Services Provided in Providers. Ann Hornsby, (4. 10) 7. Jennifer Harlow, (4. Medicare Advantage Encounter Data Issues. Thomas Hamilton, (4. Organ Transplant Center Issues. Jennifer Phillips, (4. Midnight Rule Benchmark Issues. End Further Info. End Preamble. Start Supplemental Information. SUPPLEMENTARY INFORMATION: Inspection of Public Comments: All public comments received before the close of the comment period are available for viewing by the public, including any personally identifiable or confidential business information that is included in a comment. We post all public comments received before the close of the comment period on the following Web site as soon as possible after they have been received: http: //www. Follow the search instructions on that Web site to view public comments. Electronic Access. This Federal Register document is also available from the Federal Register online database through Federal Digital System (FDsys), a service of the U. S. Government Printing Office. This database can be accessed via the Internet at: http: //www. Tables Available Only Through the Internet on the CMS Web Site. In the past, a majority of the tables referred to throughout this preamble and in the Addendum to the proposed rule and the final rule were published in the Federal Register as part of the annual proposed and final rules. However, beginning in FY 2. IPPS tables and LTCH PPS tables are no longer published in the Federal Register. Instead, these tables are available only through the Internet. The IPPS tables for this proposed rule are available only through the Internet on the CMS Web site at: http: //www. Medicare/medicare- Fee- for- Service- Payment/Acute. Inpatient. PPS/index. Click on the link on the left side of the screen titled, “FY 2. IPPS Proposed Rule Home Page” or “Acute Inpatient—Files for Download”. The LTCH PPS tables for this FY 2. Internet on the CMS Web site at: http: //www. Medicare/Medicare- Fee- for- Service- Payment/Long. Term. Care. Hospital. PPS/index. html under the list item for Regulation Number CMS- 1.
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