Dive Brief:
- The federal government’s refusal to let Partners HealthCare fix a math mistake at one of its hospitals could cost Massachusetts hospitals upwards of $110 million, the Boston Business Journal reports.
- The error involved miscalculated wages used to set Medicare reimbursement rates, but wasn’t identified until after the deadline for submitting the information had passed.
- Rhode Island hospitals stand to lose $7 million in funding because their reimbursement rates are tied to Massachusetts’ data, according to WPRI in Providence.
Dive Insight:
The snafu occurred when consultants for 19-bed Nantucket Cottage Hospital miscalculated the number of hours physicians worked, assuming more hours, which reduced the hourly rate and, consequently, reimbursement rates for all hospitals in the state. While $26 million of the reimbursement cut was already slated, $84 million is directly due to bad math.
Under the Inpatient Prospective Payment System, Medicare must reimburse hospitals at least as much as it does rural hospitals, and Nantucket Cottage Hospital set the baseline for reimbursement in the state. Earlier reports noted the mistake may cost up to 2,000 individuals in the Bay State their job.
In denying Partners’ request change its data, the Centers for Medicare & Medicaid Services said it was merely enforcing established policy.
“We have consistently stated in annual IPPS rulemaking that hospitals that do not meet the procedural deadlines set forth in IPPS rules will not be afforded a later opportunity to submit wage index data corrections,” CMS ruled. “Therefore, we are not incorporating the adjustments requested by Nantucket Cottage Hospital for the FY 2017 final rule wage index.”
The decision was included in a rule outlining how inpatient payment rates will be made for the coming year.