hospitals that are excluded from the medicare acute care pps (such as childrens hospitals) are paid based on?
Hospitals that are excluded from the Medicare Acute Care Prospective Payment System (PPS), such as children's hospitals, are paid based on a different payment methodology called the Children's Hospital Graduate Medical Education (CHGME) Payment Program.
To find out how these hospitals are paid, you can follow these steps:
1. Start by researching the specific regulations and guidelines set by the Centers for Medicare & Medicaid Services (CMS) regarding payments to excluded hospitals. Visit the CMS website or use a search engine to find official documentation, such as the Medicare Provider Reimbursement Manual or the Federal Register.
2. Look for information regarding the CHGME Payment Program, which is specifically designed to provide federal funding to children's hospitals that train residents. This program compensates for the additional costs associated with teaching hospitals and the education of physicians.
3. Analyze the provisions within the CHGME Payment Program that define the payment methodology for these excluded hospitals. These provisions may include factors such as hospital size, the number of residents being trained, and the costs involved in comprehensive pediatric training programs.
4. To gain a comprehensive understanding of the payment process, consult the Centers for Medicare & Medicaid Services directly or reach out to hospital associations and professional societies that specialize in the care of children or excluded hospitals. They can provide you with additional information and insights.
Remember, it's important to rely on official sources and trusted organizations for the most accurate and up-to-date information on payment methodologies for hospitals excluded from the Medicare Acute Care PPS.