President Bush signed legislation that prevents CMS from fully implementing $20 billion in prospective payment cuts to hospital inpatient Medicare services over the next five years. The cuts are part of a so-called "behavioral offset" contained in the IPPS in final rule which takes effect October 1, 2007. The legislation reduces the cuts in 2008 and 2009 by half, from 1.2%to 0.6% and from 1.8: to 0.9% respectively, but leave the 2010 cut of 1.8% intact.

 

Medicare payment of inpatient claims for discharges in early October should begin flowing to providers by no later than Monday, according to CMS. CMS expects fiscal intermediaries to begin processing the claims by October 18th, after updating claims processing software to reflect changes to the fiscal year 2008 IPPS.

 

 

# of Inpatients

# of Outpatients

# of Carve Out services

    Implants

    Prosthetics

# of High cost drugs

# of Days-medical necessity

$ of Charges-medical necessity

# of Days-overturned after

    appeal and review

# of Timely Filing

# of Eligibility

# of Days-Authorization

$ of Charges-Authorization

# of Days Benefits exhausted

# of Days Denied Coverage 

# of High Dollar Review

$ of High Dollar Review

# of Underpayments

$ of Underpayments