Pierluisi: CMS Proposed Rule Would Increase Medicare Payments to Puerto Rico Hospitals

A new rule proposed by the Centers for Medicare and Medicaid Services would modify how hospitals in Puerto Rico are reimbursed for Medicare services by extending more state-like treatment to hospitals there, said Resident Commissioner Pedro Pierluisi on Monday.

The rule would extend state-like treatment to Puerto Rico hospitals for the “capitol costs” portion of how hospitals are reimbursed for Medicare services, Pierluisi said a release. That, combined with recently-passed legislation that increased the base rate Puerto Rican hospitals received from Medicare to the same level as states, could increase Medicare payments to hospitals on the island by nearly $12 million a year.

A bill that Pierluisi had introduced last year was incorporated into last year’s consolidated appropriations bill increased the base rate that Puerto Rico hospitals receive from Medicare payments by about 14 percent to make it even with what states receive.

“The proposed rule just issued by CMS will help ensure Puerto Rico hospitals are treated equitably under the Medicare DSH program,” Pierluisi. “There is still much work that remains to be done to ensure that Puerto Rico is treated fairly under federal health programs, whether it be Medicaid, traditional Medicare or Medicare Advantage, but it is important to pause and acknowledge the progress we are making towards this goal.”

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