Wednesday, April 14, 2021
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CMS provides update and final rule on low-volume payment adjustment

The Centers for Medicare & Medicaid Services (CMS) announced an update on the implementation of section 50204 of the Bipartisan Budget Act (BBA) of 2018, which extends temporary changes to the low-volume payment adjustment through federal fiscal year (FY) 2018.

For FY 2018, low-volume hospitals will continue to be defined as those that are more than 15 road miles from another comparable hospital and that have up to 1,600 Medicare discharges. In order to receive the enhanced payments for FY 2018, a hospital must notify its Medicare Administrative Contractor (MAC) that it qualifies by May 29, per the instructions outlined in the notice. CMS states that it will be issuing guidance on the exact manner in which it intends to make low-volume payments for FY 2018, given that a portion will be made retroactively.

For FY 2019 through 2022, the discharge thresholds would be modified to 500 total discharges and 3,800 total discharges. To receive the enhanced payments for FY 2019, a hospital must notify its MAC that it qualifies by Sept. 1, per the instructions outlined in the rule.

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