Medicare program; changes to the hospital inpatient prospective payment systems and fiscal year 2008 rates.
Medicare program; changes to the hospital inpatient prospective payment systems and fiscal year 2008 rates.
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医疗保险计划；
DOI：
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发表时间：
2007
期刊：
影响因子：
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通讯作者：
Hhs Centers for Medicare Medicare Services
中科院分区：
文献类型：
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作者：
Hhs Centers for Medicare Medicare Services
我们正在修改医疗保险医院住院预期支付系统（IPPS）的运营和资本相关成本，以实施我们对这些系统的持续经验所产生的变化，并实施2005年赤字削减法案（Pub. L. 109-171），医疗保险改进和扩展法案根据B分部，标题I的税收减免和医疗保健法案的2006年（Pub。L. 109-432），和流行病和所有危险准备法（Pub。L. 109-417）。此外，在本最终规则的附录（含评论期）中，我们描述了用于确定医疗保险医院住院服务运营成本和资本相关成本费率的金额和因素的变化。此外，我们亦会为不包括在医疗保险计划内的若干医院和医院单位，订明加幅上限，而这些医院和医院单位是按合理成本基准支付，但须受这些上限所规限，或部分的未来支付制度款项是按合理成本原则支付。这些变化适用于2007年10月1日或之后发生的排放。在这一最终规则与评论期，作为我们努力的一部分，以进一步完善诊断相关组（DRG）系统下的IPPS，以更好地认识患者的疾病严重程度，2008财年，我们正在采用医疗保险严重DRG（MS DRG）分类系统的IPPS。2008财政年度的LTCH预期支付系统（简称MS-LTC-DRG）也采用了MS-DRG系统的结构。在我们正在做出的其他政策决定和变化中，我们正在做出与以下方面有关的变化：对MS-DRGs病例重新分类的有限修订，MS-LTC-DRGs的相对权重;新技术和医疗服务附加付款的应用;用于计算2008财年工资指数的工资数据，包括职业组合数据;向医院支付研究生医学教育的间接费用;提交医院质量数据;关于适用与1986年《紧急医疗和劳动法》有关的制裁的规定;关于披露医院医生所有权和病人安全措施的规定;以及关于向被刑事当局拘留的受益人提供服务的规定。
We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs to implement changes arising from our continuing experience with these systems, and to implement certain provisions made by the Deficit Reduction Act of 2005 (Pub. L. 109-171), the Medicare Improvements and Extension Act under Division B, Title I of the Tax Relief and Health Care Act of 2006 (Pub. L. 109-432), and the Pandemic and All Hazards Preparedness Act (Pub. L. 109-417). In addition, in the Addendum to this final rule with comment period, we describe the changes to the amounts and factors used to determine the rates for Medicare hospital inpatient services for operating costs and capital-related costs. We also are setting forth the rate of increase limits for certain hospitals and hospital units excluded from the IPPS that are paid on a reasonable cost basis subject to these limits, or that have a portion of a prospective payment system payment based on reasonable cost principles. These changes are applicable to discharges occurring on or after October 1, 2007. In this final rule with comment period, as part of our efforts to further refine the diagnosis related group (DRG) system under the IPPS to better recognize severity of illness among patients, for FY 2008, we are adopting a Medicare Severity DRG (MS DRG) classification system for the IPPS. We are also adopting the structure of the MS-DRG system for the LTCH prospective payment system (referred to as MS-LTC-DRGs) for FY 2008. Among the other policy decisions and changes that we are making, we are making changes related to: limited revisions of the reclassification of cases to MS-DRGs, the relative weights for the MS-LTC-DRGs; applications for new technologies and medical services add-on payments; the wage data, including the occupational mix data, used to compute the FY 2008 wage indices; payments to hospitals for the indirect costs of graduate medical education; submission of hospital quality data; provisions governing the application of sanctions relating to the Emergency Medical Treatment and Labor Act of 1986 (EMTALA); provisions governing the disclosure of physician ownership in hospitals and patient safety measures; and provisions relating to services furnished to beneficiaries in custody of penal authorities.