Department of Health and Human Services, Centers for Medicare and Medicaid Services: Medicare Program; Change in Methodology for Determining Payment for Extraordinarily High-Cost Cases (Cost Outliers) Under the Acute Care Hospital Inpatient and Long-Term Care Hospital Prospective Payment Systems
GAO-03-886R: Jun 23, 2003
- Full Report:
GAO reviewed the Department of Health and Human Services, Centers for Medicare and Medicaid Services' (CMS) new rule on changes in methodology for determining payment for extraordinarily high-cost cases (cost outliers) under the acute care hospital inpatient and long-term care hospital prospective payment systems. GAO found that (1) the rule would revise the methodology for determining payments for extraordinarily high-cost cases (cost outliers) made to Medicare-participating hospitals udner the acute care hospital inpatient prospective payment system; and (2) CMS complied with applicable requirements in promulgating the rule.