Federal Register - August 13, 2021
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Source: Federal Register
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Federal Register / Vol. 86, No. 154 / Friday, August 13, 2021 / Rules and Regulations
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primarily due to the changes in GAFs, and are generally consistent with the projected changes in payments due to changes in the wage index and policies affecting the wage index, as shown in Table I in section I.G. of this Appendix A.
The net impact of these changes is an estimated 0.9 percent increase in capital payments per case from FY 2021 to FY 2022
for all hospitals as shown in Table III.
The geographic comparison shows that, on average, hospitals in both urban and rural classifications would experience an increase in capital IPPS payments per case in FY 2022
as compared to FY 2021. Capital IPPS
payments per case will increase by an estimated 0.9 percent for hospitals in urban areas while payments to hospitals in rural areas will increase by 1.5 percent in FY 2021
to FY 2022.
The comparisons by region show that the estimated increases in capital payments per case from FY 2021 to FY 2022 for all urban areas ranging from a 0.2 percent increase for the West South Central region to a 1.5
percent increase for the New England and
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South Atlantic regions. We also estimate that all rural regions are expected to experience an increase in capital payments per case from FY 2021 to FY 2022, ranging from 0.8 percent for the Pacific rural region to 2.3 percent for the West South Central rural region. These regional differences are primarily due to the changes in the GAFs and estimated changes in outlier and DSH payments.
All Hospital types of ownerships Voluntary, Proprietary, and Government are expected to experience an increase in capital payments per case from FY 2021 to FY 2022.
Government hospitals are expected to experience an increase in capital IPPS
payments of 0.4 percent, and the projected increase in capital payments for proprietary and voluntary hospitals is estimated to be 1.0
percent and 0.9 percent, respectively.
Section 1886d10 of the Act established the MGCRB. Hospitals may apply for reclassification for purposes of the wage index for FY 2022. Reclassification for wage index purposes also affects the GAFs because that factor is constructed from the hospital wage index. To present the effects of the
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hospitals being reclassified as of the publication of this final rule for FY 2022, we show the average capital payments per case for reclassified hospitals for FY 2022. Urban reclassified hospitals are expected to experience an increase in capital payments of 0.3 percent; urban nonreclassified hospitals are expected to experience an increase in capital payments of 1.3 percent. The lower expected increase in payments for urban reclassified hospitals compared to urban nonreclassified hospitals is primarily due to estimated decreases in capital DSH payments to urban reclassified hospitals caused by the increase in the number of hospitals that reclassify from urban to rural under 412.103. Section 401 Reclassified Hospitals that is, hospitals that reclassify from urban to rural under 412.103 are expected to experience a decrease in capital payments of 0.1 percent. The estimated percentage increase for both rural reclassified and nonreclassified hospitals is 1.4 percent.
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