CMS may increase hospital outpatient payments by 1.9%
The Centers for Medicare & Medicaid Services (CMS) have released a final rule with comment period to revise the Medicare Hospital Outpatient Prospective Payment System (HOPPS) for calendar year (CY) 2012 to implement applicable statutory requirements and changes arising from the continuing experience with the system.
The final rule will increase payment rates under the HOPPS by 1.9 percent in CY 2012, according to CMS. The increase is based on the projected hospital inpatient market basket percentage increase of 3 percent for inpatient services paid under the Hospital Inpatient Prospective Payment System (HIPPS) minus the multifactor productivity adjustment of 1 percentage points and minus a 0.1 percentage point adjustment, both of which are required by the Patient Protection and Affordable Care Act (PPACA).
The final rule also provides a payment adjustment for designated cancer hospitals as required by the PPACA. This payment adjustment is expected to increase payments to cancer hospitals by 11.3 percent (or approximately $71 million) over what they would have otherwise been paid.
Filed Nov. 1, the rule will be published in the Nov. 30 Federal Register. “In addition, this final rule updates the revised Medicare ambulatory surgical center (ASC) payment system to implement applicable stator requirements and changes arising from the continuing experience with the system,” the rule stated. “We set forth the relative payment weights and payment amounts for services furnished in ASCs, specific healthcare common procedure coding system (HCPCS) codes to which these changes apply and other rate setting information for CY 2012 ASC payment system.”
Through the rule, CMS will be allowing eligible hospitals and critical access hospitals (CAHs) participating in the Medicare EHR Incentive Program to meet the clinical quality measure reporting requirement of the EHR Incentive Program for payment year 2012 by participating in the 2012 Medicare EHR Incentive Program Electronic Reporting Pilot.
“Finally, we are making changes to the rules governing the whole hospital and rural provider exceptions to the physician self-referral prohibition for expansion of facility capacity and changes to provider agreement regulations on patient notification requirements,” the rule concluded. CMS projected that total payments to more than 4,000 hospitals paid undee HOPPS in CY 2012 will be approximately $41.1 billion and that payments to approximately 5,000 Medicare-participating ASCs paid under the ASC Payment System will be approximately $3.5 billion for CY 2012.
The final rule with comment period will be effective Jan. 1, 2012. Comments will be taken until 5pm EST on Jan. 3, 2012.
The final rule will increase payment rates under the HOPPS by 1.9 percent in CY 2012, according to CMS. The increase is based on the projected hospital inpatient market basket percentage increase of 3 percent for inpatient services paid under the Hospital Inpatient Prospective Payment System (HIPPS) minus the multifactor productivity adjustment of 1 percentage points and minus a 0.1 percentage point adjustment, both of which are required by the Patient Protection and Affordable Care Act (PPACA).
The final rule also provides a payment adjustment for designated cancer hospitals as required by the PPACA. This payment adjustment is expected to increase payments to cancer hospitals by 11.3 percent (or approximately $71 million) over what they would have otherwise been paid.
Filed Nov. 1, the rule will be published in the Nov. 30 Federal Register. “In addition, this final rule updates the revised Medicare ambulatory surgical center (ASC) payment system to implement applicable stator requirements and changes arising from the continuing experience with the system,” the rule stated. “We set forth the relative payment weights and payment amounts for services furnished in ASCs, specific healthcare common procedure coding system (HCPCS) codes to which these changes apply and other rate setting information for CY 2012 ASC payment system.”
Through the rule, CMS will be allowing eligible hospitals and critical access hospitals (CAHs) participating in the Medicare EHR Incentive Program to meet the clinical quality measure reporting requirement of the EHR Incentive Program for payment year 2012 by participating in the 2012 Medicare EHR Incentive Program Electronic Reporting Pilot.
“Finally, we are making changes to the rules governing the whole hospital and rural provider exceptions to the physician self-referral prohibition for expansion of facility capacity and changes to provider agreement regulations on patient notification requirements,” the rule concluded. CMS projected that total payments to more than 4,000 hospitals paid undee HOPPS in CY 2012 will be approximately $41.1 billion and that payments to approximately 5,000 Medicare-participating ASCs paid under the ASC Payment System will be approximately $3.5 billion for CY 2012.
The final rule with comment period will be effective Jan. 1, 2012. Comments will be taken until 5pm EST on Jan. 3, 2012.