Medicare Program; Prospective Payment System for Long-Term Care Hospitals: Annual Payment Rate Updates and Policy Changes
medicare · Centers for Medicare and Medicaid Services · Rule · Published 2004-05-07 · Effective 2004-07-01 · 69 FR 25674
Document
Document number
04-10039
Federal Register citation
69 FR 25674
CFR reference
42 CFR 412
Type
Rule
Action
Final rule.
Category
medicare
Sub-agency
Centers for Medicare and Medicaid Services
Publication date
2004-05-07
Effective date
2004-07-01
HHS docket
CMS-1263-F
Abstract
This final rule updates the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs). The payment amounts and factors used to determine the updated Federal rates that are described in this final rule have been determined based on the LTCH PPS rate year. The annual update of the long-term care diagnosis- related group (LTC-DRG) classifications and relative weights remains linked to the annual adjustments of the acute care hospital inpatient diagnosis-related group system, and will continue to be effective each October 1. The outlier threshold for July 1, 2004 through June 30, 2005 is also derived from the LTCH PPS rate year calculations. In this final rule, we also are making clarifications to the existing policy regarding the designation of a satellite of a LTCH as an independent LTCH. In addition, we are expanding the existing interrupted stay policy and changing the procedure for counting days in the average length of stay calculation for Medicare patients for hospitals qualifying as LTCHs.