Southwest Consulting Associates Blog

FY 2020 IPPS Final Rule Posted

Posted by Jamie Pennington on Aug 2, 2019 4:40:07 PM

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2020 IPPS proposed ruleThe FY 2020 Inpatient Prospective Payment System (IPPS) Final Rule was put on display for public inspection on August 2, 2019, and is scheduled to be published in the Federal Register on August 16, 2019.  The pre-publication version can be viewed HERE or on the FY 2020 IPPS Final Rule homepageThese changes will go into effect October 1, 2019.  


Quick highlights regarding the Medicare DSH and Uncompensated Care Payments which begin on page 950 of the pre-publication version are:

  1. The uncompensated care pool to be distributed to qualifying hospitals has been established at $8.351 billion, which is a decrease of $138 million from the FY 2020 proposed rule.

  2. CMS is phasing out the use of low-income days to calculate a hospital's Factor 3 for UC payments.

  3. CMS will use only one year of Medicare cost report data versus a three-year blend as it had in the past.

  4. They will use S-10 data (Line 30) from FFY 2015 cost reports.

  5. CMS started FFY 2017 Worksheet S-10 data audits in July 2019, with the goal of having the FY 2017 audited data available for future rule-making.

  6. CMS noted a forthcoming Paper Reduction Act (PRA) package for Form CMS 2552-10 that includes proposed changes to the Worksheet S-10 instructions. A public comment period will be provided for questions about and suggestions for modifications to Worksheet S-10. We will be monitoring this closely if released.

  7. CMS would not indicate if FFY 2017 data would be used during FY 2021 rule-making.

  8. CMS noted that they will take the comments submitted in regards to reducing Provider Reimbursement Review Board (PRRB) appeals related to a hospital's Medicaid fraction into consideration for future rule-making.

Finally, hospitals have until August 31st to submit their comments on the accuracy of the FY 2020 IPPS Final Rule Factor 3 table and supplemental data files published in conjunction with the rule. 


Southwest Consulting Associates will be reviewing and analyzing the details of the final rule in its entirety including data components, and will be providing more extensive details and conclusions in future posts.  Stay tuned and be sure to subscribe to our blog below to get those posts sent directly to your inbox.

Southwest Consulting Associates Worksheet S-10 blog


Additionally, SCA is putting together our annual final rule webinar happening in late August.  If you have not already, please save your seat below and we will notify you once the date, time and registration link are available.

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Topics: Medicare DSH Reimbursement, Industry Updates, S-10, regulations, proposed rule, worksheet s-10, factor 3, uncompensated care payment, ipps rule, provider reimbursement

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The climate of provider reimbursement is ever-changing and this blog is intended to keep you up-to-date on the latest information regarding:

  • DSH Reimbursement
  • 340B Pharmacy Drug Discount Program
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