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With CMS' newly released Medicare hospital inpatient prospective payment system for FY2013, a new Medicare rule highlighting the Massachusetts rural floor discussion affirms the "Bay State Bailout" Dr. Coburn warned about earlier this year. 

According to the CMS rule, the following section highlights the rural floor discussion:

"...There was one urban IPPS hospital that was reclassified to rural Massachusetts (under section 1886(d)(8)(E) of the Act) which established the Massachusetts rural floor, but the wage index resulting from that hospital’s data was not high enough for any urban hospital to benefit from the rural floor policy. However, beginning with the FY 2012 wage index, the rural floor for the State is established by the conversion of a CAH to an IPPS hospital that is geographically located in rural Massachusetts. We estimate that Massachusetts hospitals will receive approximately a 5.5 percent increase in IPPS payments due to the application of rural floor."

Earlier this year in a Senate Finance Committee hearing, Dr. Coburn questioned HHS Secretary Sebelius on this special deal for Massachusetts asking about this provision under the PPACA and specifically - why HHS did not warn Congress of the manipulative provision benefitting Massachusetts but costing other states a total of $4 billion.

Read more about about the "Bay State Bailout" and Dr. Coburn's warning here.