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Medicare Readmission Reduction Calculation
I came across a simple explanation of how CMS will calculate readmission reduction payments. Remember that the reduction applies to 3 categories: heart failure, acute myocardial infarction, and pneumonia. First, CMS tells us that the reductions are calculated using the excess readmission ratio, which is …
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Tax Equity and Fiscal Responsibility Act (TEFRA) on Medicare cost report worksheet D-1
I’d like to speak briefly about the TEFRA calculations on D-1, Lines 54-59. The Tax Equity and Fiscal Responsibility Act was passed as a ceiling on the rate of increases in inpatient operating costs. It is calculated, in part, by dividing the hospital’s base year …
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Required Graduate Medical Education documentation
What documents are you required to maintain for purposes of GRE? 42 CFR 413.75 provides guidance: (1) The name and social security number of the resident. (2) The type of residency program in which the individual participates and the number of years the resident has …
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Direct Graduate Medical Education (GME) – Part 1
The purpose of this post is to discuss direct graduate medical education (GME). I will provide an overview of what is required on E-3, Part IV on 2552-96 or the new E-4 on the 2552-10. GME compensates hospitals for the costs of running a teaching …
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Reconcilition of Outlier Payments: How the Cost-to-Charge Ratio (CCR) Matters
In this post, I’d like to explain what happens when your final settled CCR is different from your priced CCR. I discussed before in the outlier discussion that the ratio of cost-to-charge (RCC or CCR) matters. However, this calculation is used merely to price your …
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