Table of Contents
MEDICARE SEVERITY DIAGNOSIS-RELATED GROUP (MS-DRG) CLASSIFICATIONS AND RELATIVE WEIGHTS …………………………………………………….3
MS-DRG DOCUMENTATION AND CODING ADJUSTMENT………………………………………………………………………………………………………………………………3
SPECIFIC MS-DRG CLASSIFICATIONS ……………………………………………………………………………………………………………………………………………………………………………………..3
ADD-ON PAYMENTS FOR NEW SERVICES AND TECHNOLOGIES ……………………………………………………………………………………………………………………….10
CHANGES TO MS-DRGS SUBJECT TO THE POSTACUTE CARE TRANSFER AND MS-DRG SPECIAL PAYMENT POLICIES …………………………………..14
PAYMENT ADJUSTMENT FOR MEDICARE DISPROPORTIONATE SHARE HOSPITALS (DSHS) FOR FY 2018………………………………………………………..15
PAYMENTS FOR INDIRECT AND DIRECT GRADUATE MEDICAL EDUCATION COSTS ………………………………………………………………………….17
MEDICARE GME AFFILIATED GROUPS FOR NEW URBAN TEACHING HOSPITALS ………………………………………………………………………………………….17
NOTICE OF CLOSURE OF TWO TEACHING HOSPITALS AND OPPORTUNITY TO APPLY FOR AVAILABLE SLOTS ……………………………………………………18
REVISIONS OF HOSPITAL INPATIENT ADMISSION ORDERS DOCUMENTATION REQUIREMENTS UNDER MEDICARE PART A …………………….18
QUALITY REPORTING & VALUE BASED PURCHASING PROVISIONS……………………………………………………………………………………………………………………………….20
HOSPITAL READMISSIONS REDUCTION PROGRAM…………………………………………………………………………………………………………………………..20
HOSPITAL VALUE-BASED PURCHASING (VBP) PROGRAM: POLICY CHANGE ……………………………………………………………………………………………………………….21
HOSPITAL-ACQUIRED CONDITION (HAC) REDUCTION PROGRAM ………………………………………………………………………………………………………………………………..26
HOSPITAL INPATIENT QUALITY REPORTING (IQR) PROGRAM……………………………………………………………………………………………………………………………………..29
PPS-EXEMPT CANCER HOSPITAL QUALITY REPORTING (PCHQR) PROGRAM………………………………………………………………………………………………………………..36
LONG-TERM CARE HOSPITAL QUALITY REPORTING PROGRAM (LTCH QRP) ………………………………………………………………………………………………..40
CHANGES TO THE MEDICARE AND MEDICAID EHR INCENTIVE PROGRAMS (NOW THE MEDICARE AND MEDICAID PROMOTING INTEROPERABILITY PROGRAMS)…………………………………………………………………………………………………………………………42
REQUIREMENTS FOR HOSPITALS TO MAKE PUBLIC A LIST OF THEIR STANDARD CHARGES VIA THE INTERNET …………………………………………….58
REVISIONS REGARDING PHYSICIAN CERTIFICATION AND RECERTIFICATION OF CLAIMS …………………………………………………………………….59
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