CCN 250078 Rewrote Everyone's 2027 Rate Book
CMS filed a sixteen-page correction to the FY 2027 inpatient rule Monday morning. Two provider records were wrong, and fixing them moved the relative weights, every wage index, the standardized amounts, the capital rate, the outlier threshold and Factor 3 for all 2,274 DSH hospitals, effective Thursday. Also this week: two add-on payment code lists were wrong, hospitals stop attesting a year earlier than the printed rule said, and the October outpatient rate book is still missing.
One hospital was filed as something it is not, and the repair reached every inpatient rate in the country.
CMS put a sixteen-page correction to the FY 2027 IPPS and LTCH final rule on public inspection Monday at 8:45 a.m., and it publishes today. It takes effect Thursday, which is also the day the fiscal year it prices begins.
The rule it corrects ran 892 pages on August 4 and has sat untouched for eight weeks. Two earlier correcting documents this year, CMS-1849-CN and CN2, both went to the proposed rule.
This is the first one the final rule has taken.
Two Provider Records, One Rate Book
CCN 250078 is a current IPPS hospital. Building FY 2027, CMS treated it as one that had converted to rural emergency hospital status, which pulled its data out of the MS-DRG relative weights, out of the wage index, and out of what the correction calls "other ratesetting calculations."
The second record runs the other way. CCN 360068 requested rural reclassification under 412.103, then timely canceled the request, and CMS missed the cancellation.
Its wages sat inside the Ohio rural wage index and the rural floor all summer.
Restoring one record and correcting the other forced a rebuild that CMS lists itself: "the MS-DRG relative weights, all wage indexes (and geographic adjustment factors (GAFs)), all budget neutrality factors, the fixed-loss cost threshold, and the national operating standardized amounts and capital Federal rate."
Then the knock-ons.
250078 turns out to be DSH-eligible for FY 2027, which moved the total uncompensated care amount, which moved Factor 3 for all 2,274 estimated DSH hospitals, which moved the fixed-loss threshold again. The LTCH wage index runs off the same wage data, so the LTCH standard Federal rate moved too.
Now, the national numbers that came out the other side are tiny, and not one of them shifts by a tenth of a percent (chart below).
The outlier fixed-loss threshold came down $15, to $49,331. The capital Federal rate lost eight cents, to $539.95, and the LTCH standard Federal rate lost $5.82, to $52,126.94.
Both national average hourly wages dropped a penny. The biggest move in the whole document is modeled total operating Federal payments, up $75,846,980 against an $86.0 billion base, or +0.09%.
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