What’s New on the Readmission Corner

HCAF would like to thank our Associate Member, Myla R. Reizenof Jones Walker LLP for submitting this series.

There have been many new developments on the readmissions front over the past several months. This is the second part of a four part series in which we are going to highlight some available information concerning readmissions.

What are some Highlights about the Hospital Readmissions Reduction Program?

The Centers for Medicare & Medicaid Services (“CMS”) published information about the Hospital Readmissions Reduction Program (the “Program”) on August 19, 2013. In general, the Program requires a reduction to a hospital’s payment to account for excess readmissions of selected applicable conditions. For fiscal years 2013 and 2014, the conditions are Heart Failure, Pneumonia and Acute Myocardial Infarction. For fiscal year 2015, additional measures are being added. These include: (1) patients admitted for an acute exacerbation of chronic obstructive pulmonary disease (COPD); and (2) patients admitted for elective total hip arthroplasty (THA) and total knee arthroplasty (TKA).

In addition to the above, certain exclusions to the measures are being added to account for additional planned readmissions.

With respect to the reduction for payment, the readmission payment adjustment factors for fiscal year 2014 can be no more that a 2% reduction. As referenced in our prior article last week, there was a payment cap of 1% for fiscal year 2013.

Last week, our article summarized what the new penalty information looked like for hospitals.

Please let us know if you have any questions concerning this article or readmissions in general.

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