tci Medicare Compliance & Reimbursement - 2003 Issue 10

Hospitals: OUTLIER RULE COULD HELP HONEST HOSPITALS

Hospitals that have played by the rules when it comes to Medicare outlier payments could actually see an increase in their outlier reimbursement under changes to the system outlined in a March 5 rule from the Centers for Medicare & Medicaid Services. At least that’s what CMS chief Tom Scully says. “The new policy will achieve a balance between paying hospitals fairly for high cost cases and limiting outlier payments to the 5 to 6 percent of total inpatient spending that Congress mandated,” Scully said Feb. 28. “We anticipate that the changes … will stop...

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