Tag archives: Outpatient Prospective Payment System

CMS publishes CY 2019 changes to hospital outpatient prospective payment and ambulatory surgical center payment systems and quality reporting programs final rule

On November 2, CMS published its CY 2019 hospital outpatient prospective payment and ambulatory surgical center payment systems and quality reporting programs final rule. In the final rule CMS implements its proposal to pay clinic visit services performed in excepted off-campus provider-based departments (PBDs) a Medicare Physician Fee Schedule – equivalent payment rate. These services … Continue reading

Senate tax bill would effectively repeal ACA individual mandate; House legislation to reverse 340B Drug Discount Program cuts; CMS addresses prescription drug costs and the opioid crisis

On November 14, Senate Finance Committee Chairman Orrin Hatch (R-UT) released the Chairman’s Mark to the Senate version of the Tax Cuts and Jobs Act. Hatch’s version of the tax plan effectively repeals the Affordable Care Act (ACA) individual mandate by reducing the associated penalty to $0. The ACA individual mandate requires individuals to buy … Continue reading

CMS issues 2018 hospital OPPS and home health PPS final rules

On November 1, 2017, the Centers for Medicare & Medicaid Services (CMS) issued its final hospital outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) payment system final rule for Calendar Year (CY) 2018.  On the same day CMS also issued its home health prospective payment system 2018 final rule.      OPPS payment rates will … Continue reading

Senate delays vote on health care bill; CMS issues OPPS and physician fee schedule proposed rules; House subcommittee to hold hearing on 340B drug pricing program

As reported last week , on Thursday U.S. Senate Republican leadership released their latest version of the “Better Care Reconciliation Act of 2017.” The Congressional Budget Office score of the revised bill was expected today, with Senator Majority Leader Mitch McConnell intending for the full Senate to debate and vote on the legislation this week. However, last … Continue reading

President signs into law 21st Century Cures Act

On December 13th, President Obama signed into law the 21st Century Cures Act.  The legislation authorizes $4.8 billion for the National Institutes of Health to fund new initiatives in precision medicine, cancer, neuroscience, and regenerative medicine.  The bill also provides $500 million over ten years for the Food and Drug Administration for the development of … Continue reading

CMS Issues CY 2017 Final Rule

On November 1, 2016, CMS issued its Calendar Year (CY) 2017 Outpatient Prospective Payment System (OPPS) final rule with comment period. CMS also issued an interim final rule with comment period that establishes Medicare Physician Fee Schedule (MPFS) rates for certain items and services furnished by certain hospital off-campus outpatient departments. Significant provisions of the … Continue reading

CY 2017 OPPS Final Rule and Hospital Off-Campus Outpatient Department Payment Implications

On Tuesday, November 1, CMS published its Calendar Year 2017 Outpatient Prospective Payment System (OPPS) final rule with comment period.  The final rule includes provisions implementing the Bipartisan Budget Act of 2015, Section 603.  On the same date CMS also issued an interim final rule with comment period that establishes Medicare Physician Fee Schedule (MPFS) … Continue reading

U.S. House of Representatives approves legislation affecting off-campus hospital outpatient department Medicare payments

On November 2, 2015, President Obama signed into law the Bipartisan Budget Act of 2015 (BBA 2015).  BBA 2015, Section 603 generally provides that beginning January 1, 2017, off-campus hospital outpatient departments (HOPDs) will no longer be paid under the Medicare outpatient prospective payment system (OPPS) but rather under another applicable payment system, provided the … Continue reading
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