Comments to CMS on a Proposed Rule Impacting Medicare Fee-for-Service (FFS) Hospital Inpatient Payments

The Business Group submitted comments on a proposed rule (CMS-1735-P) supporting refinements in quality improvement programs and expressing concerns with a CMS proposal to use private payer negotiated rates to reweight Medicare Severity-Diagnosis Related Groups (MS-DRGs) for FFS reimbursement.

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July 08, 2020

Specifically, the Business Group supported CMS efforts to refine various quality improvement programs, (namely the Hospital-Acquired Condition Reduction Program (HAC), Hospital Inpatient Quality Reporting Program (IQR)), to better adjust payments within Medicare FFS for quality and outcomes. Additionally, we support greater public disclosure of meaningful quality information, in this case disclosure of eCQMs data for the first time. The Business Group also expressed concerns about the use of private payer negotiated rates to reweight MS-DRGs for FFS reimbursement because they may not be representative, could lead to distortions and other problems.

Comments to CMS on a Proposed Rule Impacting Medicare Fee-for-Service (FFS) Hospital Inpatient Payments

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