Inpatient PPS Rule - Easier to Understand in E-Book Format

Rayellen Kishbach's picture

CMS has published the FY2015 IPPS Final Rule Rule, and MediRegs makes reading and understanding this rule easier with our electronic book version and payment data files. In this blog article, I will tell you where to find IPPS resources and what to expect in your product alerts.


For a quick review of the FY2015 IPPS Rule, check out the Presentation Slides from our FY2015 IPPS Final Review webinar.

Electronic Book

For each of the major PPS Final and Proposed Rules, we convert the hundreds of pages of text to an electronic book broken into chapters and sections. This feature makes bookmarking and searching so much easier!

  • In the Compliance and Regulation Suite or Audit and Revenue Resource Center, you can find this in the Inpatient library, on the Inpatient "browse by subject" page, and on the CFR/FR special search page. In all products, it is in the Guidance for Coders Library.
  • When updates are published, we will put them in this same location, so you can search across the proposed rule, final rule, and corrections simultaneously.

Federal Register Daily Update

We post the rules every day!

  • Subscribers to the Compliance & Regulation Suite and Audit & Revenue Resource Center are notified of the rule on the day it is published, as part of the regular Daily E-Mail Alert or What's New. Subscribers to other health care products will see this rule and a link to the text in the Week In Review newsletter.
  • Please note that we generally see updates and corrections to the IPPS rule that range from minor typographical fixes to major corrections. You should monitor for correction notices.
  • ****Expert tip: You can store a search to get instant alerts when new articles related to IPPS are published. A great search term for this is the special ID number assigned within the Federal Register to each rule. For 2015 IPPS, search for this term, then click to add it to your stored searches.: CMS-1607-* Update

Understanding the rule often requires an examination of the data behind the rule.

  • Any data files published by Medicare at the IPPS web site will then appear in the daily alert as well. Watch for the IPPS page "Index of FY 2015 IPPS Proposed Rule Home Page", and click through to see a sortable table that incudes the impact file, and other supporting data. Please note that we generally see revisions and updates to this page.
  • ****Expert tip: We update the INDEX page automatically, so when you get to that page, click the BOOKMARK button. Your bookmark will automatically take you to the updated page.

IPPS Payment Data Files & Calculator

This year's rule proposes major changes to how payment to individual providers are paid; in recent years, we've seen MAJOR delays in the CMS PC Pricer files, which has caused confusion for providers and payers alike. We work directly with New Health Analytics to provide provider-specific payment calculators and data files. This gives our clients up-to-date payment for all MS-DRGs and acute care or long term care providers, with archives. If you need, we can provide payment projections based on calculations built from the impact file. Please be in touch if you are struggling to understand IPPS reimbursement!