Fed Regist. 1984 Aug 31;49(171):34728-97.
This final rule amends the Medicare regulations published as an interim final rule on September 1, 1983 (48 FR 39752) and a final rule on January 3, 1984 (49 FR 234). Those regulations implement section 1886 of the Social Security Act, which changes the method of payment for inpatient hospital services from a cost-based, retrospective reimbursement system to a prospective payment system based on diagnosis-related groups. In addition, in the addendum to this final rule, we are making changes in the methods, amounts, and factors necessary to determine prospective payment rates for Medicare inpatient hospital services applicable to discharges occurring on or after October 1, 1984, in the case of the Federal portion of the payment, and effective with hospital cost reporting periods beginning on or after October 1, 1984, in the case of the hospital-specific portion. These changes are applicable in the second year of the three-year transition period for the prospective payment system. We are also implementing in this final rule certain changes in the inpatient hospital prospective payment system resulting from the enactment of Pub. L. 98-369 on July 18, 1984.
本最终规则修订了于1983年9月1日作为临时最终规则发布（《联邦法规汇编》第48卷，第39752页）以及于1984年1月3日作为最终规则发布（《联邦法规汇编》第49卷，第234页）的医疗保险法规。这些法规实施了《社会保障法》第1886条，该条将住院医院服务的支付方式从基于成本的追溯报销系统改为基于诊断相关组的前瞻性支付系统。此外，在本最终规则的附录中，我们正在对确定适用于1984年10月1日及之后出院的医疗保险住院医院服务前瞻性支付费率所需的方法、金额和因素进行修改，对于支付的联邦部分而言是如此；对于医院特定部分而言，则自1984年10月1日及之后开始的医院成本报告期起生效。这些修改适用于前瞻性支付系统三年过渡期的第二年。我们还在本最终规则中实施了因1984年7月18日颁布的第98 - 369号公法而对住院医院前瞻性支付系统做出的某些修改。
