CMS Issues Proposed Rule Updating Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems.

Date posted: August 1, 2017

The Centers for Medicare & Medicaid Services (CMS) recently proposed changes to the Hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgical Center (ASC) Payment System. Annual updates to the OPPS and ASC payment system involve changes to payment policies, rates, and quality provisions relating to Medicare patients who receive care at hospital outpatient departments or surgical centers.

Selected key provisions of the proposed rule include:

  • Payment Policy Changes for the OPPS, including notably:
    • A two-year moratorium on the direct supervision requirement at rural hospitals and critical access hospitals, reducing the burden on rural hospitals.
    • A change in payment rates for certain Medicare Part B drugs that hospitals purchase through the 340B program. Additionally, CMS requests comment on how it can pass related regulatory savings on to beneficiaries and providers.
  • Policy changes for ASC payments;
  • Removal of certain measures from the Hospital Outpatient Quality Reporting Program requirements;
  • Addition and removal of various reporting measures in the Ambulatory Surgical Center Quality Reporting Program. Further, CMS requests comments on the Ambulatory Breast Procedure Surgical Site Infection Outcome measure for inclusion in the ASCQR Program.

CMS is also releasing a Request for Information regarding transparency, flexibilities and efficiencies in the Medicare program. CMS will accept public comments on the proposed rule until September 11, 2017.

The proposed rule is available at:  https://www.federalregister.gov/documents/2017/07/20/2017-14883/medicare-program-hospital-outpatient-prospective-payment-and-ambulatory-surgical-center-payment.

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