In addition, we note that in response to comments in the FY 2021 IPPS/LTCH PPS final rule (85 FR 59015 through 59016), we increased the burden estimate from 15 hours to 20 hours after consideration of comments stating that additional effort would be necessary to crosswalk discharges to an MS-DRG, specifically if a hospital is not familiar with the MS-DRG classification system, for use in calculating the median payer-specific negotiated charges
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Comment: One commenter pointed to the significant methodological changes to individual measures finalized in the Fiscal Year (FY) 2026 Inpatient Prospective Payment System (IPPS) final rule (90 FR 36997 through 37027), such as the use of Medicare Advantage (MA) data, changes in risk adjustment models, removal of COVID-19 vaccination measures, and re-baselining of HAI measures, and urged CMS to delay implementation of Stage 2 for a year after updated data is publicly available and after conducting a comprehensive analysis of the combined effects before finalizing further penalties
I also requested a medical necessity letter and had it in my inbox by the next morning
For example, a recent scientific investigation proposed that the potential impacts of Tesamorelin on muscle tissue integrity may be examined using CT scans
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