Files for FY 2014 Final Rule and Correction Notice

Title
Files for FY 2014 Final Rule and Correction Notice
Fiscal Year
2014
Type of File
Tables and Data Files
Description
See Below
  1. Impact File: The impact file contains data elements by provider that were used in calculating the final FY 2014 rates and impacts. The zip file for this download contains the following 3 zip files:
    • FY_14_FR_Impact_File.zip: The final rule impact file released on August 1, 2013
    • FY 2014 Final Rule IPPS Impact PUF-CN2-IFC-Sept 2013.zip: An updated impact released in September 2013 which contains corresponding corrections made through September 2013.
    • FY 2014 Final Rule IPPS Impact PUF-CN1-IFC-Jan 2014.zip: An updated impact file released January 2014 which contains corresponding corrections reflecting the changes in the January 2, 2014 correction notice. This file is the most updated impact file and also includes the updates from file number 2.
  2. AOR/BOR File: This zip file contains two excel spreadsheets, one for the After Outliers Removed (AOR) and one for the Before Outliers Removed (BOR). There are also two files containing the variable descriptions. The variables in these files are used in the calculations of the relative weights as well as other calculations for the inpatient PPS. All text files in the zip file are for 508 compliance.
  3. Case Mix Index File: This file contains the non-transfer adjusted case mix index (CMI) based on the MS-DRGs billed on the claim in the year the claim was incurred (that is, during FY 2012, using the V29 Grouper).
  4. Standardizing File: This file is used to standardize charges for the rate building process.
  5. Historical Weight File: DRG weights and other data since the inception of Inpatient PPS (See imbedded header for each year for layout).
  6. County to CBSA Crosswalk File: This file lists the CBSA, SSA county code and FIPS county code for all counties. Any changes to the CBSAs through March 2010 have been incorporated.
  7. Wage Index Public Use Files: Open Attached Zip file. Attached is a PDF with a description of each zip file. Main zip file contains 6 zip files.
    • FY 2014 Final Rule Wage Index PUFs; S3 Part II and Occ Mix Data
    • FY 2014 Final Rule Average Hourly Wage by Provider and CBSA Public Use File
    • FY 2014 Final Occupational Mix Adjusted and Unadjusted Average Hourly Wages by Provider
    • FY 2014 Final Occupational Mix Adjusted and Unadjusted Average Hourly Wages and Pre-Reclass Wage Indexes by CBSA
    • FY 2014 Final Occupational Mix Factor by Provider PUF
    • FY 2014 Final Rule AHW by Provider Area Listing
  8. Hospital Readmissions Reduction Program Supplemental Data File: This file contains the FY 2014 payment adjustment factors under the Hospital Readmissions Reduction Program (including corrections through September 2013), the number of qualifying cases, number of cases excluded, and excess readmissions ratios for the three conditions (heart failure, pneumonia and acute myocardial infarction) used to calculate the payment adjustment factors.
  9. Medicare DSH Supplemental Data File: This file contains the data to support the implementation of Section 3133 of the ACA, Improvements to Medicare DSH Payments (including corrections through September 2013). The file contains the data used for Medicare DSH estimates to support of the calculation of Factor 1. In addition, the file contains the data to calculate a hospital’s uncompensated care payment, including the FY 2014 Factor 3, the data used to calculate Factor 3, DSH eligibility status and the data to calculate the interim per claim uncompensated care payment. A hospital’s Factor 3 is the proportion of the uncompensated care amount that a DSH hospital will receive under the implementation of Section 3133 of the Affordable Care Act. Factor 3 is the hospital's Medicaid days and Medicare SSI days relative to all DSH hospitals proposed Medicaid days and Medicare SSI days. DSH hospitals are identified as those hospitals that are projected to receive DSH for FY 2014.
  10. Definition of Medicare Code Edits: This file contains a description of each coding edit with corresponding ICD-9-CM code lists. There are two chapters in this file. The first chapter contains all the edits and the code lists for FY 2014. The second chapter summarizes, by edit, the changes in the edit code list from the last release of the MCE. This document is 508 compliant.
  11. Table 1A-1E: This excel spreadsheet contains the final FY 2014 Operating and Capital National and Puerto Rico Specific Standardized Amounts.
  12. Wage Index Final Rule and Correction Notice Tables:
    • Final Rule Contains Tables 2, 3A, 3B, 4A, 4B, 4C, 4D, 4E, 4F, 4J, 9A, 9C
    • Correction Notice Tables: 2-CN, 3A-CN, 4A-CN, 4C-CN, 4J-CN
  13. Table 5: List of MS-DRGs, Relative Weighting Factors and Geometric and Arithmetic Mean Length of Stay.
  14. Tables 6G-6K: Table 6B New Procedure Codes; Table 6G Additions to the CC Exclusions List; Table 6H Deletions from the CC Exclusions List. Table 6I Complete MCC list; Table 6J Complete CC list; Table 6K Complete list of CC exclusions for the MS-DRGs.
  15. Tables 7A and 7B: Tables 7A and 7B contain the number of discharges, and selected percentile lengths of stay for both MS-DRGs, version 30 and MS-DRGs, version 31.
  16. Tables 8A, 8B, and 8C: Tables 8A and 8B contain the FY 2014 IPPS operating and capital statewide average cost-to-charge-ratios. Table 8C contains the FY 2014 LTCH statewide average cost-to-charge-ratios.
  17. Table 10: Table 10 contains the cost thresholds by MS-DRG for the cost criteria for new technology add on payment applications for FY 2015.
  18. Table 14: List of Hospitals with fewer than 1,600 Medicare discharges based on the March 2013 update of the FY 2012 MedPAR file and potentially eligible hospitals' FY 2014 Low-Volume Payment Adjustment for discharges occurring before April 1, 2014. Eligibility for the low-volume payment adjustment is also dependent upon meeting the mileage criteria specified at section 412.101(b)(2)(ii) of the regulations.  This table was included with the interim final rule with comment period CMS-1599-IFC2 published in the Federal Register on March 18, 2014, which implements the changes to the payment adjustment for low-volume hospitals provided for by the Pathway for SGR Reform Act of 2013.
  19. Table 15: FY 2014 Readmission adjustment factors under the Hospital Readmissions Reduction Program, which are based on excess readmission ratios from the performance period of July 1, 2009 to June 30, 2012. This file includes the FY 2014 readmission adjustment factors established in the FY 2014 Final Rule (CMS-1599-F) and the subsequent corrections to those factors made in September 2013 (CMS-1599-CN2).
  20. Hospital VBP Tables 16A and 16B:
    • Table 16A: Contains the proxy adjustment factors under the Value-Based Purchasing (VBP) Program that were calculated using historical baseline and performance periods. These proxies for the FY 2014 Hospital VBP payment adjustment factors will not be used to adjust hospital payments. This file includes the proxy adjustment factors published for the FY 2014 Final Rule (CMS-1599-F) and the subsequent corrections to those proxy adjustment factors made in September 2013 (CMS-1599-CN2).
    • Table 16B: Contains the actual payment adjustment factors under the Hospital Value-Based Purchasing (VBP) Program for FY 2014. These actual factors are based on the finalized baseline and performance period for FY 2014 and will be used to adjust base operating DRG payments to eligible hospitals for discharges occurring in FY 2014.

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