Implementation of edits for the Emergency Department (ED) adjustment policy under the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS)
Section 124 of the Medicare, Medicaid, and SCHIP (State Children"s Health Insurance Program) Balanced Budget Refinement Act of 1999 (BBRA) (Pub. L.106-113), mandated that the Secretary develop a per diem PPS for inpatient hospital services furnished in psychiatric hospitals and psychiatric units. The IPF PPS was implemented January 2005. One aspect of the IPF PPS included an ED adjustment policy. Recently, the Office of Inspector General, drafted a report, entitled "Nationwide Review of Medicare Part A Emergency Department Adjustments for Inpatient Psychiatric Facilities During Calendar Years 2006 and 2007" (A-01-09-00504). Based on findings in this report, CMS is implementing edits for ED adjustments where the costs for the emergency department services are already covered by another Medicare payment.
Final
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: February 11, 2011
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