Imputed Rural Floor

The rural floor was created to correct the anomaly of some urban hospitals being paid less than the average rural hospital in their states cms must apply the rural floor in a manner that is budget neutral on a national level which means that for any increase in wage indexes for hospitals based on getting the rural floor cms must.

Imputed rural floor.

Although delaware is an all urban state no hospital benefits from their imputed rural floor because the cbsa wage index values for each cbsa that impacts a delaware hospital are greater than the imputed rural floor. The letter notes that the wage based medicare reimbursement disparity created when the policy was ended as part of the. The agency also restates that a new occupational mix adjustment based on calendar year cy 2016 will be applied beginning in fy 2019 per statutory requirement to collect data every three. This has led to some.

Cms finalizes its proposal to allow the imputed rural floor to expire for all urban states which includes delaware new jersey and rhode island. We write to urge you to reinstate the imputed rural floor a longstanding policy correcting a wage index disparity for hospitals in rhode island in the proposed fiscal year fy 2020 inpatient prospective payment system ipps. In rhode island 4 of the 11 hospitals will receive the benefit of the imputed rural floor. From fy 2013 to fy 2018 the ipps rules have included an alternative methodology for calculating the imputed rural.

Cms is also finalizing changes to the wage index rural floor that will remove urban to rural hospital reclassifications from the calculation of the rural floor wage index value beginning in fy 2020. Cms has decided not to extend the policy for fy 2019 stating it creates a disadvantage to hospitals in states with rural hospitals but no urban hospitals receiving the rural floor. The rural floor comes into play because the inpatient medicare wage index for an urban hospital within a given state can t be less than a rural hospital in the same state.