FY 2024 Geographic Reclassification Deadlines
Deadline to submit an application for a FY 2024 MGCRB reclassification and a request for cancellation of a withdrawal or termination (reinstatement): September 1, 2022.
Date of FY 2024 Wage Index Reclassification Determinations Issued by the MGCRB: January 31, 2023
Deadline for Hospitals to appeal FY 2024 MGCRB Wage Index Reclassification Determinations: February 15, 2023 (Per 412.278, 15 days after Determinations Issued by the MGCRB)
Deadline to withdraw an application or terminate an approved 3-year MGCRB reclassification (must be received by the MGCRB with a copy to CMS at wageindex@cms.hhs.gov within 45 days from the date NPRM is issued): June 15, 2023
Deadline to waive Lugar/accept out-migration adjustment or reinstate Lugar/cancel outmigration adjustment (must send written notification to CMS at wageindex@cms.hhs.gov within 45 days from the date of public display of NPRM): May 25, 2023
To ensure proper accounting, we request hospitals to include their CCN, and either “waive Lugar” or “reinstate Lugar”, in the subject line of these requests.
Deadline for hospital to be treated as rural in the FY 2024 wage index and budget neutrality calculations (412.103 lock in, 60 days after NPRM is displayed): June 9, 2023
Deadline for hospitals to cancel 412.103 rural reclassification by submitting a request to the CMS regional office, effective with next FFY: June 2, 2023 (not less than 120 days prior to the end of a Federal fiscal year, and for requests submitted after October 1, 2021, not less than 1 calendar year after the effective date of the rural reclassification).
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The MGCRB is independent of CMS and the deadlines listed on this website are a courtesy only. The MGCRB makes the final decision regarding the date of the deadlines above and whether a request is timely. The public should confirm any deadline above with the MGCRB. For complete details on MGCRB reclassification, please click on the link to the MGCRB web page in the Related Links section below. |
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| To view the wage index data files, see the "Wage Index Files" link in the left navigational area of this page or see the "Related Links Inside CMS" section below. |
Section 1886(d)(3)(E) of the Social Security Act requires that, as part of the methodology for determining prospective payments to hospitals, the Secretary must adjust the standardized amounts “for area differences in hospital wage levels by a factor (established by the Secretary) reflecting the relative hospital wage level in the geographic area of the hospital compared to the national average hospital wage level.” This adjustment factor is the wage index. We currently define hospital geographic areas (labor market areas) based on the definitions of Core-Based Statistical Areas (CBSAs) established by the Office of Management and Budget and announced in December 2003. The wage index also reflects the geographic reclassification of hospitals to another labor market area in accordance with sections 1886(d)(8)(B) and 1886(d)(10) of the Act.
The Act further requires that we update the wage index annually, based on a survey of wages and wage-related costs of short-term, acute care hospitals. Data included in the wage index derive from the Medicare Cost Report, the Hospital Wage Index Occupational Mix Survey, hospitals' payroll records, contracts, and other wage-related documentation. In computing the wage index, we derive an average hourly wage for each labor market area (total wage costs divided by total hours for all hospitals in the geographic area) and a national average hourly wage (total wage costs divided by total hours for all hospitals in the nation). A labor market area's wage index value is the ratio of the area's average hourly wage to the national average hourly wage. The wage index adjustment factor is applied only to the labor portion of the standardized amounts.
As an expert in healthcare reimbursem*nt and Medicare policy, I bring a wealth of knowledge to decipher the intricacies of the FY 2024 Geographic Reclassification Deadlines outlined in the provided article. With a deep understanding of the Medicare program and its reimbursem*nt mechanisms, I can shed light on the nuances of the processes involved and provide context to the mentioned concepts.
Firstly, the article revolves around the Medicare Geographic Classification Review Board (MGCRB) and its role in determining the geographic reclassification of hospitals for the fiscal year 2024. The deadlines presented are critical milestones in this complex process.
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FY 2024 MGCRB Reclassification Application Deadline (September 1, 2022): Hospitals seeking reclassification must submit their applications by this date. The MGCRB evaluates these requests, considering factors that warrant a change in geographic classification.
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Date of FY 2024 Wage Index Reclassification Determinations (January 31, 2023): The MGCRB issues determinations regarding wage index reclassifications, a crucial factor in adjusting prospective payments to hospitals based on regional wage differences.
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Deadline for Hospitals to Appeal Wage Index Reclassification Determinations (February 15, 2023): Hospitals dissatisfied with the MGCRB's determinations can appeal by this date, following regulations outlined in section 412.278.
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Deadline to Withdraw or Terminate an Approved MGCRB Reclassification (June 15, 2023): Hospitals have until this date to withdraw or terminate a previously approved 3-year reclassification.
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Deadline to Waive/Reinstate Lugar or Accept/Cancel Out-Migration Adjustment (May 25, 2023): A nuanced deadline involving hospitals' decisions on Lugar waivers, out-migration adjustments, and corresponding notifications to CMS.
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Deadline for Hospital Rural Treatment in FY 2024 Wage Index (June 9, 2023): Hospitals seeking rural classification must adhere to this deadline, affecting wage index and budget neutrality calculations.
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Deadline to Cancel 412.103 Rural Reclassification (June 2, 2023): Hospitals can cancel rural reclassification by submitting a request to the CMS regional office, with specific timing requirements.
The article emphasizes the MGCRB's independence from CMS, indicating that the listed deadlines are courtesy notifications, and final decisions rest with the MGCRB. It underscores the importance of confirming deadlines directly with the MGCRB.
The latter part of the article delves into the regulatory background, citing Section 1886(d)(3)(E) of the Social Security Act, which mandates adjustments to standardized amounts based on area wage differences. The wage index, a crucial factor in this adjustment, is annually updated using data from various sources, including the Medicare Cost Report and the Hospital Wage Index Occupational Mix Survey.
In conclusion, this comprehensive overview illustrates the meticulous process and regulatory framework involved in Medicare reimbursem*nt and geographic reclassification, showcasing my expertise in navigating the complexities of healthcare policy and reimbursem*nt mechanisms.
