Medicare program; elimination of inpatient routine nursing salary cost differential--HCFA. Final rule with comment...

Because patients age 65 and over had been presumed to require more nursing services than the general patient population, the Medicare reimbursement principles have, since 1969, recognized an inpatient routine nursing salary cost differential for hospitals and skilled nursing facilities (SNFs). Legislation enacted in 1981 limits this differential rate for hospitals to no more than 5 percent. Recent studies have cast serious doubt on the assumption that aged patients require more nursing services than do hospital patients generally. In view of these studies and in the interest of avoiding payments to providers of services that exceed the providers' reasonable costs, Pub. L. 97-248, the Tax Equity and Fiscal Responsibility Act of 1982, was enacted on September 3, 1982. Section 103 of this legislation eliminates the inpatient routine nursing salary cost differential as an element of reimbursable cost under Medicare for hospitals or SNFs.