On Monday, July 19, 2021, the Centers for Medicare & Medicaid Services (“CMS”) released its Hospital Outpatient Prospective Payment System (“OPPS”) and Ambulatory Surgery Center (“ASC”) proposed rule for Calendar Year (“CY”) 2022. In the proposed rule, CMS proposes a net increase of 2.3 percent in Medicare OPPS rates from CY 2021 to 2022 for hospitals that meet the applicable quality reporting requirements. CMS would also update the ASC rates for CY 2022 by 2.3 percent.
CMS proposes updates to the Hospital Price Transparency requirements beginning on January 1, 2022 by increasing the minimum civil monetary penalty to $300 per day for hospitals that have a bed count of less than 30 and $10 per bed per day for hospitals that have a bed count greater than 30, not to exceed $5,500 per day. If this proposal were implemented, the maximum total penalty amount per hospital would be $2,007,500 per year and the minimum total penalty amount per hospital would be $109,500 per year. The proposed rule also includes a request for information “on the health and safety standards, quality measures and reporting requirements, and payment policies for Rural Emergency Hospitals.”
CMS proposes maintaining the payment rate of Average Sale Price minus 22.5 percent for drugs and biologicals acquired under the 340B Drug Pricing Program. Finally, CMS proposes to stop the elimination of the Inpatient Only list and “to re-adopt the ASC Covered Procedures List . . . criteria that were in effect in CY 2020” that were used to add a procedure to the ASC.
For more information about the proposed rule, a CMS fact sheet may be accessed here.
CMS will accept public comments in response to the proposed rule until September 17, 2021.