FFY 2024 IPPS Proposed Rule: Low-Volume Adjustment
On April 10, the Centers for Medicare & Medicaid Services (CMS) published the FFY 2024 IPPS Proposed Rule (effective for discharges on or after October 1, 2023).” Toyon is pleased to provide our summary of Section 8: FFY 2024 IPPS Proposed Rule: Low-Volume Adjustment
As extended through FFY 2024 by Section 4101 of the 2023 CAA, CMS provides the criteria for hospitals to qualify for the additional low-volume payment:
More than 15 road miles from another subsection (d) hospital; and
Most recently submitted cost report documents less than 3,800 total discharges (whereby hospitals with less than 500 total discharges receiving the maximum 25% adjustment)
To receive the additional payment for the full fiscal year, providers have until September 1, 2023, to make a written request for low-volume status to their MAC and demonstrate that it meets the criteria for low-volume status. For requests received after September 1, the adjustment is effective prospectively within 30 days of the MAC’s low-volume status determination. This is an annual election that is not automatically updated, even if approved for FFY 2023.
For more information, please contact Robert Howey at robert.howey@toyonassociates.com.
Comments are due to CMS by Friday, June 9 via https://www.regulations.gov/ (see instructions under the “submit a comment” tab and reference file code “CMS-1785-P”). Toyon will share our comment letter in the coming weeks.