Medicare Inpatient Regulations


The Medicare program provides payment for acute inpatient care through the inpatient prospective payment system (IPPS). In addition to adjusting payments for the patient’s condition and the hospital’s geographic market conditions, the IPPS includes several policy adjustments (e.g., payment for medical education programs and disproportionate share hospital) and payment adjustments for quality-related programs such as the value-based purchasing (VBP), hospital readmissions reduction, and hospital-acquired conditions (HAC) reduction programs. As CMS updates the IPPS and associated policies, GNYHA provides members with analyses of the proposed and finalized policies and communicates comments to CMS on behalf of the membership.