The Centers for Medicare and Medicaid Services recently discovered an error that was made in the calculation of the high-cost outlier fixed-loss amount in the rate year 2008 long-term care hospital prospective payment system final rule. Under the high-cost outlier policy, Medicare pays LTCHs an additional amount for unusually high-cost cases. To be eligible for this payment, the hospital’s estimated costs in treating the case must exceed the long-term care diagnosis-related group payment by an outlier fixed-loss amount. The final rule, published in the Federal Register on May 11, 2007, sets the outlier fixed-loss amount for RY08 at $22,954, up from $14,887 in RY07.
However, the final RY08 high-cost outlier fixed-loss amount should have been $20,738. CMS expects to publish a correction notice in the Federal Register shortly. Read the notice.
