Final Rule covers a wide range of payment and other provisions.
The Centers for Medicare & Medicaid Services (CMS) wrapped up last week by unveiling a final rule associated with the Medicare Physician Fee Schedule (MPFS) and new policies governing the functions of the payment systems for the Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Centers (ASCs).
The OPPS Final Rule includes updates of payment policies, payment rates, and quality provisions for services furnished under the MPFS on and after Jan. 1, 2020. The updates include changes to:
Payment Provisions:
Other Provisions:
To review the full fact sheet published Friday by CMS on the MPFS final rule, go online to https://www.cms.gov/newsroom/fact-sheets/finalized-policy-payment-and-quality-provisions-changes-medicare-physician-fee-schedule-calendar.
The OPPS and ASC changes “aim to increase choices, encourage medical innovation, empower patients, and eliminate waste, fraud, and abuse to protect seniors and taxpayers,” CMS said in a press announcement. “The changes build on existing efforts to increase patient choice by making Medicare payment available for more services in different sites of services and adopting policy changes.”
CMS added that it is updating OPPS payment rates for hospitals that meet applicable quality reporting requirements by 2.6 percent; the figure is based on the projected hospital market basket increase of 3.0 percent, minus a 0.4 percentage point adjustment for Multi-Factor Productivity (MFP).
The update to ASC rates for 2020 was also listed at 2.6 percent, as CMS noted that it anticipates the move will “also help to promote site-neutrality between hospitals and ASCs, and encourage the migration of services from the hospital setting to the lower-cost ASC setting.”
The final rule associated with these updates, with statutorily required comment period, includes:
To review the full fact sheet published by CMS on the OPPS and ASC changes, go online to https://www.cms.gov/newsroom/fact-sheets/cy-2020-medicare-hospital-outpatient-prospective-payment-system-and-ambulatory-surgical-center-0.
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