Files for FY 2013 Proposed Rule and Correction Notice

Title
Files for FY 2013 Proposed Rule and Correction Notice
Fiscal Year
2013
Type of File
Tables and Data Files
Description
See Below
  1. Impact File: This file contains data elements by provider that were used in calculating the proposed FY 2013 rates and impacts.
  2. AOR/BOR File: This zip file contains two excel spreadsheets, one for the proposed After Outliers Removed (AOR) and one for the proposed 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 2011, using the V28 Grouper).
  4. Proposed Standardizing File: This file is used to standardize charges for the rate building process.
  5. 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.
  6. 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 2013 Proposed Rule Wage Index PUFs
    • FY 2013 Proposed Rule Average Hourly Wage by Provider and CBSA Public Use File
    • FY 2013 Proposed Occupational Mix Adjusted and Unadjusted Average Hourly Wages by Provider
    • FY 2013 Proposed Occupational Mix Adjusted and Unadjusted Average Hourly Wages and Pre-Reclass Wage Indexes by CBSA
    • FY 2013 Proposed Occupational Mix Factor by Provider PUF
    • FY 2013 Proposed Rule AHW by Provider Area Listing
  7. Hospital Readmissions Reduction Program Supplemental Data File: This file contains the proposed FY 2013 proxy payment adjustment factors under the Hospital Readmissions Reduction Program, and the number of cases and excess readmissions ratios for the three conditions (heart failure, pneumonia and acute myocardial infarction) used to calculate the proxy payment adjustment factors.
  8. Lugar Hospitals in Counties that Qualify for an Outmigration Adjustment: Beginning with FY 2010, lists each Lugar hospital (deemed urban   under section 1886(d)(8)(B) of the Act) that is located in a county that qualifies for an outmigration adjustment (Table 4J); the 3-year period for which the hospital is eligible for the outmigration adjustment; and whether or not the hospital accepted the outmigration adjustment in lieu of its urban status for each year of its 3-year eligibility.  Please note that in the FY 2012 IPPS final rule, CMS finalized a policy that allows a Lugar hospital that is eligible for and accepts the outmigration adjustment to automatically waive its urban status for the 3-year period for which the outmigration adjustment is effective.
  9. Table 1A-1E: This excel spreadsheet contains the proposed FY 2013 Operating and Capital National and Puerto Rico Specific Standardized Amounts. Additionally, there are PDFs corresponding to each tab in the spreadsheet to meet Section 508 compliance.
  10. Tables 2, 3A, 3B, 4A, 4B, 4C, 4D, 4E, 4F, 4J, 9A, 9C (Wage Index Tables): Proposed FY 2013 wage index tables
  11. Table 5: List of proposed MS-DRGs, Relative Weighting Factors and Geometric and Arithmetic Mean Length of Stay
  12. Tables 6G-6K: Tables 6G Additions to the CC Exclusions List; Table 6H Deletions from the CC Exclusions List. Table 6I Complete MCC list; Table 6I.1 Additions to the MCC list; Table 6I.2 Deletions to the MCC list; Table 6J Complete CC list; Table 6J.1 Additions to the CC list; Table 6J.2 Deletions to the CC list; Table 6K Complete list of CC exclusions for the MS-DRGs; All files are 508 compliant or have corresponding 508 compliant PDFs.
  13. Tables 7A and 7B: Tables 7A and 7B contain the number of discharges, and selected percentile lengths of stay for both MS-DRGs, version 29 and MS-DRGs, version 30 as published in the Federal Register. Additionally, there are two PDF files corresponding to each tab in the spreadsheet to meet Section 508 compliance.
  14. Tables 8A, 8B, and 8C: Tables 8A and 8B contain the proposed FY 2013 IPPS operating and capital statewide average cost-to-charge-ratios as published in the Federal Register. Tables 8C contains the proposed FY 2013 LTCH statewide average cost-to-charge-ratios as published in the Federal Register. Additionally, there are three PDF files corresponding to each tab in the spreadsheet to meet Section 508 compliance.
  15. Table 10: Table 10 contains the proposed cost thresholds by MS-DRG for the cost criteria for new technology add on payment applications for applications for FY 2014. Additionally, there is a PDF file corresponding to the table to meet Section 508 compliance.
  16. Table 15: Proposed adjustment factors under the Hospital Readmissions Reduction Program based on excess readmission ratios from an older performance period of July 1, 2007 to June 30, 2010.  It is used as a proxy adjustment for the FY 2013 readmission adjustment factor for the purpose of allowing the public to replicate the proposed methodology to calculate the adjustment factor.
  17. Table 16: The proposed adjustment factors under the Value-Based Purchasing (VBP) Program are estimated based on a hypothetical, historical period of performance.  It is used as a proxy adjustment for the FY 2013 Hospital VBP payment adjustment factor, which we will not know until the actual FY 2013 performance period ends and the values are computed.

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