2022 proposed rule on Medicare payment policies for IPPS and LTCH hospitals issued

April 28, 2021

The Centers for Medicare & Medicaid Services (CMS) issued the proposed rule for fiscal year (FY) 2022 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital (LTCH). The proposed rule would update Medicare payment policies and rates for operating and capital‑related costs of acute care hospitals and for certain hospitals and hospital units excluded from the IPPS for FY 2022. 

The proposed policies in the IPPS and LTCH PPS rule builds on key priorities to close healthcare equity gaps and support greater access to life-saving diagnostics and therapies during the public health emergency (PHE) and beyond. The rule’s provisions seek to sustain hospital readiness to respond to future public health threats, enhance the healthcare workforce in rural and underserved communities, and revise scoring, payment and public quality data reporting methods to lessen the adverse impacts of the pandemic and future unplanned events. 

The proposed rule would update Medicare fee-for-service payment rates and policies for inpatient hospitals and long-term care hospitals for fiscal year (FY) 2022. CMS is publishing this proposed rule to meet the legal requirements to update Medicare payment policies for IPPS hospitals and LTCHs on an annual basis. 

CMS proposes to establish new requirements and revise existing requirements for the Hospital Value-Based Purchasing (VBP) Program, Hospital Readmissions Reduction Program, Hospital-Acquired Condition (HAC) Reduction Program, Hospital Inpatient Quality (IQR) Reporting Program, Long Term Care Hospital (LTCH) Quality Reporting Program, PPS-Exempt Cancer Hospital Reporting (PCHQR) Program, and the Medicare Promoting Interoperability Program.  In addition, CMS is requesting comments regarding the modernization of the quality measurement enterprise to digital quality measurement. 

Consistent with Executive Order 13985 on Advancing Racial Equity and Support for Underserved Communities through the Federal Government, CMS is seeking stakeholder feedback on ways to attain health equity for all patients through policy solution. This includes enhancing hospital-specific reports that stratify measure results by Medicare/Medicaid dual eligibility and other social risk factors, ways to improve demographic data collection, and the potential creation of a hospital equity score to synthesize results across multiple measures and social risk factors.  

CMS also proposes to extend New Technology Add-on Payments for 14 technologies that otherwise would be discontinued in FY 2022. CMS also propose to extend New COVID-19 Treatments Add-on Payment (NCTAP) for eligible products through the end of the fiscal year in which the COVID-19 PHE ends. 

CMS is proposing to repeal the collection of market-based rate information on the Medicare cost report and the market-based MS-DRG relative weight methodology as finalized in the FY 2021 IPPS/LTCH PPS final rule, this proposal will avoid imposing additional unnecessary burden on hospitals. 

CMS has the release

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