Hospitals hit CMS hard on rationale for IPPS cuts

AHA claims it was kept deliberately opaque
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Hospitals continue to push back against the 0.2 percent Inpatient Prospective Payment System cut imposed by the Centers for Medicare & Medicaid Services during the 2014 fiscal year.

Four state hospital associations and four hospital systems sued CMS earlier this year over the proposed cut, which stems from projections that there would be an uptick of inpatient admissions over the two-midnight rule. The rule, intended to cut down on short-stay inpatient admissions, has been a sore point in the hospital community.

CMS recently filed a motion for summary judgment in the case. The agency's rationale for keeping the cut in place is little more than the fact that it disagrees with the public comments made against the cut, according to the American Hospital Association (AHA). It also accused CMS of opacity in how it is dealing with the public regarding the proposed rate cuts.

"CMS fails to explain away the fact that its proposed rule did not give commenters the information they needed to permit meaningful comment on CMS's proposed cuts," states the brief filed by the hospitals in the case, Shands Jacksonville Medical Center et al v. Sylvia Mathews Burwell.

It continues, "Commenters did not have access to CMS's actuaries' analysis, did not know what assumptions underlay that analysis, and did not know what data the actuaries considered relevant and what data they did not. Without any--much less all--of that information, it was impossible for commenters to cogently critique CMS's analysis. CMS, lacking any way to defend that state of affairs, attempts to cobble together statements from outside the rulemaking to prove that commenters knew the data that went into the agency's calculations. That effort fails."

The AHA brief also accuses CMS of keeping the details vague so as to prevent public commenters from providing any lucid analysis, according to AHA News Now. "The analysis was so vague as to defy detailed rebuttal," the brief states.

To learn more:
- read the AHA News Now article
- check out the CMS filing (.pdf)
- here's the AHA brief (.pdf)

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