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Partners gets no relief from its big Medicare snafu

nantucketusland

Nantucket from a NASA satellite.

The Centers for Medicaid & Medicaid Services will not let Boston-based Partners HealthCare  resubmit paperwork for 19-bed Nantucket (Mass.) Cottage Hospital that, if it had been filed correctly, would have resulted in higher Medicare payments to  hospitals across Massachusetts

CMS’ decision to deny Partners’s resubmission request was included in CMS’s Inpatient Prospective Payment Systems rule.  CMS  refused to allow the corrections because the hospital missed the original submission deadline.

Becker’s Hospital Review reports: “Under hospital payment rules, Medicare is required to reimburse employee wages at urban hospitals at the baseline set at rural hospitals in the state. Nantucket Cottage Hospital typically sets the floor for wages at hospitals across Massachusetts because it is the only rural hospital in the state.”

“Last year, the Nantucket-based hospital provided data that underestimated its wages, dragging down payments for the entire state. Partners identified the errors in mid- to late March, and sent corrected numbers April 5, almost two months after the deadline for submitting corrections.”

To read the Becker’s article, please hit this link.

 


Partners urgently trying to fix Medicare snafu

 

Partners HealthCare, trying to prevent steep declines in Medicare payments to its Massachusetts hospitals, is  urgently urging CMS to use corrected data that the Boston-based system submitted for 19-bed Nantucket (Mass.) Cottage Hospital.

As Becker’s Hospital Review notes: “Under hospital payment rules, Medicare is required to reimburse employee wages at urban hospitals at the baseline set at rural hospitals in the state. Nantucket Cottage Hospital typically sets the floor for wages at hospitals across Massachusetts because it is the only rural hospital in the state. However, that isn’t the case this year.”

“Consultants hired by Partners made several errors in the data Nantucket Cottage Hospital submitted to Medicare. The errors reduced the hourly wage rate by overestimating hours and failing to include enough overtime pay and high-paid physician hours. Due to the mistakes, Massachusetts hospitals could lose a total of $160 million in Medicare funding next year. ”

 

 

 


Partners’s big problem from a little island

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Downtown lovely but very, very pricey Nantucket.

Math  errors at  tiny  Nantucket Cottage Hospital, on the island of Nantucket, Mass., and part of giant PartnersHealthCare have created what might become a $160 million drop in Medicare payments in the Bay State over the next year.

The Boston Globe reports that the problem could cut  Medicare funding by 10 percent at some hospitals as well as  force layoffs of 2,000 staff, mostly outside of Boston, says the Massachusetts Council of Community Hospitals.

Here the nub of the Globe story:

“…Medicare must reimburse a state’s urban hospitals for employee wages at least as much as it reimburses its rural hospitals. As a result, Nantucket sets the floor for wage reimbursements at hospitals across the state. And because Nantucket’s wages are high, due to its remote island location and steep cost of living, that has created bonuses for many other Massachusetts hospitals in recent years.

“Not this year. Consultants hired by Partners made several errors that led to lower wages being reported to Medicare for Nantucket Hospital. They overestimated hours, thereby reducing the hourly rate, and did not include enough higher-paid physician hours and overtime pay, according to an e-mail from the Massachusetts Hospital Association obtained by The Globe.”

“Those mistakes, combined with another smaller adjustment to Nantucket’s wages, would result in a ‘steep and extraordinarily serious’ decline in Medicare payments, wrote the association’s general counsel, Timothy Gens, in the e-mail. He said ‘the situation is further complicated by the fact that the [Medicare] deadline for corrections has passed.’ The rates affect the next fiscal year, beginning in October.”

 

 

 


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