C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER B—MEDICARE PROGRAM › PART 412—PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES › Subpart A—General Provisions

42 C.F.R. § 412.8

Publication of schedules for determining prospective payment rates

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(a) Initial prospective payment rates—(1) For inpatient operating costs. Initial prospective payment rates for inpatient operating costs (for the period October 1, 1983 through September 30, 1984) were determined in accordance with documents published in the Federal Register on September 1, 1983 (48 FR 39838), and January 3, 1984 (49 FR 324).

(2) For inpatient capital-related costs. Initial prospective payment rates for inpatient capital-related costs (for the period October 1, 1991 through September 30, 1992) were determined in accordance with the final rule published in the Federal Register on August 30, 1991 (56 FR 43196).

(b) Annual publication of schedule for determining prospective payment rates. (1) CMS proposes changes in the methods, amounts, and factors used to determine inpatient prospective payment rates in a Federal Register document published for public comment not later than the April 1 before the beginning of the Federal fiscal year in which the proposed changes would apply.

(2) Except as provided in paragraph (c) of this section, CMS publishes a Federal Register document setting forth final methods, amounts, and factors for determining inpatient prospective payment rates not later than the August 1 before the Federal fiscal year in which the rates would apply.

(c) Publication schedule for FY 2007. For FY 2007, not later than August 1, 2006, CMS publishes a Federal Register document setting forth a description of the methodology and data used in computing the inpatient prospective payment rates for that year.

[57 FR 39820, Sept. 1, 1992, as amended at 62 FR 46025, Aug. 29, 1997; 71 FR 48136, Aug. 18, 2006]
Notes of Decisions
Cited in 5 cases, 1986–2015 · leading case: Robert Wood Johnson University Hospital, a Non-Profit Corporation v. Tommy G. Thompson, United States Department of Heal
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Robert Wood Johnson University Hospital, a Non-Profit Corporation v. Tommy G. Thompson, United States Department of Heal (2002) ca3 “§ 1395ww(d)(6); 42 C.F.R. § 412.8 . This system notifies hospitals in advance of the amount of payment they should expect to receive per patient for each DRG.”
Anna Jaques Hospital v. Sebelius (2009) cadc “See Publication of Schedules for Determining Prospective Payment Rates, 42 C.F.R. § 412.8 (2008). Because of the time required to scrub the data, the Secretary calculates each year’s wage index using data from the survey conducted three years earlier.”
Anna Jacques Hospital v. Sylvia Mathews Burwell (2015) cadc “42 C.F.R. § 412.8 . The Secretary then promulgates the final wage indi-ces as part of the Inpatient Prospective Payment System rules and policies for that year.”
Robert Wood Johnson v. Secretary HHS (2002) ca3 “§ 1395ww(d)(6); 42 C.F.R. § 412.8 . This system notifies hospitals in advance of the amount of payment they should expect to receive per patient for each DRG.”
Episcopal Hospital v. Bowen (1986) paed “§ 1395ww(d)(6), 42 C.F.R. § 412.8 (1985). 50 Fed.Reg. 3547 (Sept.”
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