tci Medicare Compliance & Reimbursement - 2003 Issue 15

Reimbursement: HOSPITALS BEMOAN OUTLIER CHANGES

Hospitals should brace themselves for potential reimbursement shortfalls under the Centers for Medicare & Medicaid Services' new outlier policy. While the policy change was explicitly crafted to deter a handful of hospitals from gaming the system, the broader effect of the new rule could strike a blow even to hospitals that play by the rules, hospital associations fear. While CMS chief Tom Scully has suggested that honest hospitals could actually fare better under the new outlier rule his agency unveiled March 5, the American Hospital Association disagrees. The changes, in addition to imposing new and unnecessary paperwork burdens, "would...

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