Medicare program; payment for the costs of malpractice insurance for hospitals and skilled nursing facilities--HCFA. Proposed rule.
We propose to amend the method we use to determine reasonable cost reimbursement for the costs of malpractice insurance incurred by hospitals and skilled nursing facilities (SNFs). Under this proposed rule, we would retain the claims-paid formula whereby a hospital or SNF would be reimbursed according to the ratio of its malpractice claims paid to Medicare patients compared to its malpractice claims paid to all patients. A hospital or SNF with no malpractice claims-paid experience would be reimbursed an amount equal to a national ratio of malpractice claims paid to Medicare patients compared to malpractice claims paid to all patients. In addition, we would update the national ratio used to determine the amount payable to hospitals with no less experience. The current malpractice insurance rule was promulgated on June 1, 1979 (44 FR 31641) and made applicable to cost reporting periods beginning on or after July 1, 1979. Since that time a number of hospitals have brought court actions challenging the policy. As a result, we have reviewed actual hospital cost report data to ascertain whether the underlying bases for the existing methodology continue to be supported. We have concluded that these data independently establish and confirm that our prior determination to directly apportion malpractice costs was correct. Accordingly, we propose to have this regulation take effect for cost reporting periods beginning on or after July 1, 1979, subject to our rules of administrative finality and reopening.
D014487:Centers for Medicare and Medicaid Services, U.S.; D007351:Insurance, Liability / Q000331:legislation & jurisprudence*; D007882:Legislation, Hospital; D006278:Medicare / Q000331:legislation & jurisprudence*; D012051:Reimbursement Mechanisms / Q000331:legislation & jurisprudence*; D012866:Skilled Nursing Facilities / Q000331:legislation & jurisprudence; D014481:United States