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Medicare / Medicaid


Medicare's Hospital Inpatient Payment System for FY2007: Final Rule

Session #: 81670-xh
Presenter(s): Larry Goldberg
Session Length: 1hr. 40 min.
Event: 2006 HFMA Audio Webcast
Date: 9-26-06

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On April 12, CMS released proposed Medicare hospital inpatient prospective payment policies that would have made significant and dramatic two-phase change to the DRG system - a move from charge-based to cost-based calculations for determining DRG weights, and expansion of the number of DRGs to make them more reflective of the severity of a patient's illness. Additionally, soon after the issuance of the proposal, CMS had to change direction with regard to the proposal's occupational mix adjustment because of a US Appeals Court ruling. The final rule, which was issued on August 1, took different directions from the earlier proposals, with impact that is considerably less than if CMS had adopted the proposed rule. But, now is not the time to relax. More changes are due before this presentation regarding the occupational mix adjustment and the wage index. The adopted and expected changes must be assessed and contingency plans made for what may lie ahead. Get the details that are known, here.



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