Rural Health Open Door Forum

**Updated July 8, 2011 - The proposed agenda for the next Rural Health Open Door Forum scheduled for Tuesday, July 12, 2011 from 2:00pm – 3:00pmET is as follows: Pre-Existing Condition Insurance Plan; Home Health Prospective Payment System; Outpatient Prospective Payment System; Advanced Diagnostic Imaging Program; Pioneer ACO Model; Physician Fee Schedule/Telehealth. If you wish to participate, dial 1-800-837-1935 Conference ID: 59683815. Please see the full participation announcement in the Downloads section below. Thank you for your continued interest in the CMS Open Door Forums.

**Additional Updated July 6, 2011 (Corrected Web Address) - Fiscal Year (FY) 2012 IPPS Proposed Rule Wage Index and Outmigration Adjustment Corrections (For Immediate Attention)

The Centers for Medicare & Medicaid Services (CMS) has become aware that an error was made in the calculation of the wage index outmigration adjustment in Table 4J of the FY 2012 IPPS-LTCH PPS proposed rule (CMS-1518-P), posted on the CMS Web site at: http://www.cms.gov/AcuteInpatientPPS/IPPS2012/list.asp#TopOfPage. The correction of this error results in an additional 104 providers being eligible for the outmigration adjustment in the FY 2012 proposed wage index. For a provider that is newly eligible for the adjustment and is not reclassified in the proposed wage index (under sections 1886(d)(8) or (d)(10) of the Social Security Act (the Act)), the correction to the outmigration adjustment also changes the provider's FY2012 wage index value listed on Table 2.

Since these changes could affect hospitals' geographic reclassification decisions for FY 2012, we are providing immediate notification of the corrections to Tables 2 and 4J of the FY 2012 IPPS/LTCH PPS proposed rule and a brief extension of the 45-day deadline of §412.273 (referenced at 75 FR 25881) for hospitals to terminate or withdraw 1886(d)(10) reclassifications as well as the 45-day deadline (referenced at 75 FR 25887) for a hospital to receive the out-migration adjustment rather than their section 1886(d)(8)(B) redesignation. A discussion of the corrections will be included in a Correction Notice to the FY 2012 IPPS/LTCH proposed rule (CMS-1518-CN2), which will be on display in the Federal Register sometime during the week of July 4, 2011. The corrections to Tables 2 and 4J are posted on CMS's Web site at: http://www.cms.hhs.gov/AcuteInpatientPPS/01_overview.asp. Hospitals that wish to request (or to revise a previous request) to terminate or withdraw an 1886(d)(10) reclassification, or to receive the out-migration adjustment rather than their section 1886(d)(8)(B) redesignation, must submit their request by no later than 7-days from the actual date of display of the Federal Register Correction Notice.

A detailed instructional letter (TDL-11384, 6-28-11, ATTACHMENT) has also been distributed to (or posted for) hospitals through their Medicare contractors and is available on CMS's Web site, also at: http://www.cms.gov/AcuteInpatientPPS/01_overview.asp, in the "Downloads" section. For questions, contact Brian Slater (410-786-5229) or Valerie Miller (410-786-4535).

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.

To learn more about Atlantic Financial Consulting you may visit their website at

http://atlanticfinancial.us  or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.