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New York State
Workers' Compensation Board
OFFICE OF THE CHAIR
20 Park Street   Albany, New York 12207
Governor David A. Paterson


Subject No. 046-423

New Reimbursement Rates For Inpatient Hospital Care

Date: May 14, 2010

The workers' compensation fee schedule for inpatient hospital care automatically tracks New York Medicaid rates, as determined by the New York State Department of Health (DOH), with limited statutory modifications. New York Public Health Law § 2807-c(1)(b-1). As required by statute, the DOH provided the Workers' Compensation Board (Board) with its revised 2009 and initial 2010 reimbursement rates for inpatient hospital care on April 19, 2010. Those new rates are now posted on the Board's web site at:

http://www.wcb.ny.gov/content/main/hcpp/MedFeeSchedules/2009medfee.jsp

http://www.wcb.ny.gov/content/main/hcpp/MedFeeSchedules/2010medfee.jsp

The rates are based on a new methodology adopted by DOH known as All Patients Refined Diagnosis Related Groups (APR-DRG). The revised 2009 rates are effective for all discharges between December 1, 2009 and December 31, 2009, and replace the 2009 rates that were received on January 4, 2010 (Subject Number 046-396, January 22, 2010). The initial 2010 rates are effective for all discharges between January 1, 2010 and December 31, 2010.

To prepare for transition to this new system, the Board, in conjunction with the DOH and its contractor, 3M Health Information Systems, held webinars in December 2009 and April 2010 regarding the new APR-DRG methodology. You can review the webinars at:

https://cc.callinfo.com/cc/schedule/display.do?udc=1d4yfkzun38ky

https://cc.callinfo.com/cc/schedule/display.do?udc=1t2sby993hqda

Additional information about the APR-DRG system is also available on the DOH's web site at:

http://www.health.ny.gov/facilities/hospital/reimbursement/apr-drg/

 

Robert E. Beloten
Chair