Alabama Department of Senior Services along with the Department of Health and Human Services are proposing a Medicare Program; Proposed Changes to the Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2012 Rates. This function of change will somewhat affect me because my younger brother recently feel ill to a stroke. In addition, he now is a Medicare recipient because of him being on disability. Furthermore, the interest delves deep because of the fact that both my mother and father is of retirement age. Also, my father is on disability.

SUMMARY: We are proposing to revise the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems and to implement certain statutory provisions contained in the Patient Protection and Affordable
Care Act and the Health Care and Education Reconciliation Act of 2010
(collectively known as the Affordable Care Act) and other legislation.
These changes would be applicable to discharges occurring on or after
October 1, 2011. We also are setting forth the proposed update to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. The proposed updated rate-of-increase limits would be effective for cost reporting periods beginning on or after October 1, 2011. We are proposing to update the payment policy and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals
(LTCHs) and implement certain statutory changes made by the Affordable
Care Act. These changes would be applicable to discharges occurring on or after October 1, 2011.

2. Describe the proposal/change Answer: In my opinion I think that the proposal of change can be an asset and is a benefit of the recipients. I think the theory is that the payment method will be simpler. In addition, the payment will move quicker to Hospital Inpatient facilities. However, my concern anytime changes occur to Medicare it may or may not be something in the fine print that will limited or affect basic Medicare coverage.

3. Write the public comment which you would submit to this proposal. If the proposed regulation deadline has already passed, write the comment you would have submitted. Explain briefly what you wish to accomplish with your comment. Answer: To Whom It May Concern I do agree with the Medicare Program; Proposed Changes to the Hospital Inpatient Prospective Payment Systems if this change create a quicker form of payment I am all for it. However, my concern is within the changes of Medicare as so many Americans, I do not agree with internal Medicare changes (coverage’s). Also, in the proposed plan Effects under Proposed Payment Rate Changes and Policy Changes under the LTCH PPS; If there will be policy changes I demanded that you highlight them and bring to the forefront those said changes. Thank you. Provide the "deadline" by which the public comment must be made. (If the date has already passed, please provide when the deadline was).
Answer: October 2012

5- A. Once you have submitted your comment, what will you be legally entitled to do later in the promulgation process (if you should choose to do so)? (See the textbook's discussion of the Administrative Procedure Act.)
Answer: Passed the act in 1946 The Administrative Procedure Act is designed to give uniformity to the rule-making and adjudicative proceedings of federal administrative agencies.
The Administrative Procedure Act allows public participation. In addition, it Allow the public a chance to comment on the rule before final adoption. Also, it requires publish a notice of proposed rulemaking in the Federal Register Once commented on us as Americans have that right.
b. If the proposal passes, identify and explain the five legal theories you could use in an attempt to have the regulation declared invalid and overturned in court.
Answer: The first, ground on which to challenge is that the proposal is unconstitutional.
The Second, is on the grounds that it is arbitrary capricious, and abuse of discretion. This is standard and generally applied to informal rule making and force agencies to show evidence to support the propose rule.
The Third is that the regulation is not supported by substantial evidence. This rule applies in the review of formal rule making where the arbitrary and capricious standard simply requires proof.
The fourth ground is to challenge on that the rule can be set aside if the agency did not apply with the APA requirement of notice.
The Fifth, I think is Ultra Vires this goes beyond the authority given to the agency in its enable act.
c. Which of these challenges would be the best way to challenge the regulation you selected for this assignment if you wanted to have the regulation overturned and why?
Answer: In my opinion the best way to combat this challenge is the third theory regulation is not supported by substantial evidence. This is the only challenge that I can think of.