News: CMS releases FY 2019 IPPS proposed rule

CMS released the fiscal year (FY) 2019 IPPS proposed rule on Tuesday, April 24. The rule includes updates to quality initiatives and changes to the 2019 ICD-10-CM/PCS codes. Coming in at 1,883 pages, this year’s proposal tops last year’s by 51 pages.

The rule also includes modifications to the electronic health record (EHR) incentive program to “greater promote interoperability” and to make the EHR incentive program "more flexible and less burdensome,” according to the release.

In line with the current CMS administration’s goal of reducing reporting burdens, the proposed rule would reduce the number of measures that acute care hospitals are required to report across the five quality and value-based purchasing programs.

Should the proposed rule be finalized, a total of 19 measures would be removed and 21 would be de-duplicated. CMS proposed adding one claims-based readmissions measure, according to the release. According to CMS, measures were proposed for removal if they were:

• Duplicative
• “Topped out” (meaning that the overwhelming majority of providers were performing well on them)
• Excessively burdensome to report

The rule also proposes increases to payment rates by 1.75% for acute care hospitals that participate in the Hospital Inpatient Quality Reporting Program and are meaningful EHR users. When taken in stride with other proposed payment adjustments, CMS projects that total Medicare spending on inpatient hospital services will increase by about $4 billion in FY 2019. 

Editor’s note: To read the full 2019 IPPS proposed rule, click here. To read CMS’ release, click here. To read about why CDI professionals should stay abreast of healthcare regulatory changes, read the November/December 2017 edition of the CDI Journal.