CMS Finalizes 2024 Hospital Inpatient Payment Changes
The Centers for Medicare & Medicaid Services recently issued the 2024 Medicare hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) final rule. Noteworthy for orthopaedics, the agency finalized the removal of Hospital-level Risk-Standardized Complication Rate (RSCR) Following Elective Primary Total Hip Arthroplasty and/or Total Knee Arthroplasty measure from the Hospital IQR Program in conjunction with the adoption of the recent updates to the measure in the Hospital Value-Based Purchasing Program. CMS also finalized the proposal to adopt the substantive measure modification to the Hospital-level RSCR following Elective Primary THA/TKA, adding additional mechanical complication ICD-10 codes to the measure, beginning with the April 1, 2025, through March 31, 2028, reporting period/FY 2030 payment determination. For physician-owned hospitals, CMS finalized that for a hospital to submit and receive Medicare payment for services referred by a physician owner or investors, the hospital must satisfy all of the requirements of the whole hospital exception or the rural provider exception to the physician self-referral law, commonly referred to as the “Stark Law.” |
