Sens. Menendez, Cramer Lead a Bipartisan Coalition of 34 Senators in Requesting CMS to Adjust Proposed Payment Update in Final IPPS Rule

Source: United States Senator for New Jersey Bob Menendez

WASHINGTON, D.C. – U.S. Senators Bob Menendez (D-N.J.) and Kevin Cramer (R-N.D.) today led a bipartisan coalition of 34 Senate colleagues in requesting the Centers for Medicare and Medicaid Services Administrator, Chiquita Brooks-LaSure, use the agency’s special exceptions and adjustments authority to update the proposed payment update in the final inpatient prospective payment system rule.

“We write today to express our concern regarding the proposed payment updates included in the Centers for Medicare & Medicaid Services’ (CMS) inpatient prospective payment system (IPPS) proposed rule for fiscal year (FY) 2024,” wrote the senators to Administrator Brooks-LaSure. “We are concerned that the proposed payment updates do not fully account for the current cost of care and will result in an overall payment reduction for hospitals in FY2024.”

The senators highlighted that in the FY2024 proposed rule, CMS relies on historical data that does not predict the impact of the current elevated cost of providing care and the increased growth in expenses due to labor and supply chain costs. They also pointed out that the productivity update included in the proposed rule assumes hospitals can replicate the general economy’s productivity gains, when in fact hospitals and health systems continue to face productivity declines.

“Conditions like the ones currently facing hospitals require a heightened review of payment policy. We respectfully request that CMS consider using its special exceptions and adjustments authority to make a retrospective adjustment to account for the difference between the market basket update that was implemented for FY 2022 and what the market basket actually is for FY 2022,” added the senators. “These important changes will ensure Medicare payments for acute care services more accurately reflect the cost of providing hospital care today and for the coming year. On behalf of our hospitals and health systems nationwide, we appreciate your attention to these concerns.”

This effort is supported by the American Hospital Association.

“The American Hospital Association (AHA) thanks Senators Menendez and Cramer for leading this important bipartisan effort urging CMS to ensure hospitals and health systems have the resources they need to continue delivering high-quality care to their patients and communities,” said Lisa Kidder Hrobsky, AHA Senior Vice President, Advocacy and Political Affairs. “This support is more needed than ever as the hospital field continues to confront rising inflation, workforce shortages and surging costs for supplies and drugs.”

Sens. Menendez and Cramer were joined by Sens. Debbie Stabenow (D-Mich.), Shelley Moore Capito (R-W.V.), Mike Rounds (R-S.D.), Roger Wicker (R-Miss.), Alex Padilla (D-Calif.), Jerry Moran (R-Kan.), Cindy Hyde-Smith (R-Miss.), Richard Blumenthal (D-Conn.), Kirsten Gillibrand (D-N.Y.), Peter Welch (D-Vt.), Tom Carper (D-Del.), Sheldon Whitehouse (D-R.I.), Susan Collins (R-Maine), Angus King (I-Maine), Mark Warner (D-Va.), Jacky Rosen (D-Nev.), John Boozman (R-Ark.), Chris Coons (D-Del.), J.D. Vance (R-Ohio), Katie Britt (R-Ala.), Thom Tillis (R-N.C.), James Lankford (R-Okla.), Tommy Tuberville (R-Ala.), Sherrod Brown (D-Ohio), Amy Klobuchar (D-Minn.), Tina Smith (D-Minn.), Dianne Feinstein (D-Calif.), Raphael Warnock (D-Ga.), John Hoeven (R-N.D), James Risch (R-Idaho), Marsha Blackburn (R-Tenn.), and Bill Hagerty (R-Tenn.).

The full text of the letter can be found HERE and below:

Dear Administrator Brooks-LaSure,

We write today to express our concern regarding the proposed payment updates included in the Centers for Medicare & Medicaid Services’ (CMS) inpatient prospective payment system (IPPS) proposed rule for fiscal year (FY) 2024. We are concerned that the proposed payment updates do not fully account for the current cost of care and will result in an overall payment reduction for hospitals in FY2024. We request CMS consider using its special exceptions and adjustments authority to update the proposed payment update in the final IPPS rule.

In the FY2024 proposed rule, CMS relies on historical data that does not predict the impact of the current elevated cost of providing care and the increased growth in expenses due to labor and supply chain costs. Additionally, the productivity update included in the proposed rule assumes hospitals can replicate the general economy’s productivity gains. However, in reality the critical financial pressures that hospitals and health systems continue to face have resulted in productivity declines, not gains. 

Conditions like the ones currently facing hospitals require a heightened review of payment policy. We respectfully request that CMS consider using its special exceptions and adjustments authority to make a retrospective adjustment to account for the difference between the market basket update that was implemented for FY 2022 and what the market basket actually is for FY 2022. These important changes will ensure Medicare payments for acute care services more accurately reflect the cost of providing hospital care today and for the coming year.

On behalf of our hospitals and health systems nationwide, we appreciate your attention to these concerns. We look forward to working with you on these important issues.

Sincerely,

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