Fletcher C J
Arthur Anderson, Miami, FL, USA.
Healthc Financ Manage. 1996 Mar;50(3):22-5.
The Tax Equity and Fiscal Responsibility Act (TEFRA) limits cost-per-case rate increases for inpatient care delivered by healthcare providers excluded from Medicare's prospective payment system. Costs beyond these limits normally are not reimbursed. Under certain circumstances, however, healthcare providers can receive reimbursement beyond TEFRA limits by petitioning for an adjustment from their fiscal intermediaries and the Health Care Financing Administration. Although the request process often is lengthy, providers who can thoroughly document substantial increases in the cost of delivering care due to extraordinary circumstances, significant wage, increases, or noncompatibility of cost-reporting periods may be granted relief in the form of a rate adjustment and, in rare cases, the assignment of a new base year.
《税收公平与财政责任法案》（TEFRA）限制了被排除在医疗保险预期支付系统之外的医疗服务提供者提供住院护理的每例成本费率增长。超出这些限制的成本通常不予报销。然而，在某些情况下，医疗服务提供者可以通过向其财政中介机构和医疗保健财务管理局申请调整，获得超出TEFRA限制的报销。尽管申请过程通常很长，但那些能够充分证明由于特殊情况、大幅工资增长或成本报告期不兼容导致提供护理成本大幅增加的提供者，可能会获得费率调整形式的救济，在极少数情况下，还会获得新基年的指定。
