Along with its annual updates to the inpatient-only list, the 2020 Outpatient Prospective Payment System (OPPS) final rule finalized a proposal that will give hospitals a grace period to adjust internal policies for procedures recently removed from the inpatient-only list.
CMS is moving forward with multiple policies—effectively based on reducing reimbursement to hospitals—that have been deemed unlawful in court, according to the 2020 OPPS final rule, released Friday, November 1. However, the agency pushed its controversial price transparency proposals to a separate, yet-to-be released final rule.
A federal judge rejected CMS’ motion to reconsider or issue a stay on her September order to vacate cuts to reimbursement to grandfathered off-campus provider-based departments.
Approximately 25% of the $3.8 trillion spent annually in the U.S. on healthcare can be characterized as waste, according to an analysis recently published in the Journal of the American Medical Association.
While the calendar year 2020 OPPS proposed rule is shorter than in prior years (819 pages for the display version), the proposed policies therein pack a punch and may be thought of as a new day dawning for the future of hospital services.
CMS could have saved its beneficiaries an additional $2.9 million in 2017 had it implemented a more expansive price substitution policy for Part B drugs, according to an Office of Inspector General (OIG) report.
CMS released the fiscal year (FY) 2020 IPPS final rule on August 2, increasing inpatient operating payment rates by 3.1%, significantly altering rural health payments, and expediting opportunities to pay for new technologies. Policy updates affect approximately 3,300 acute care hospitals and apply to discharges occurring on and after October 1.
CMS released the 2020 OPPS proposed rule July 29, proposing to refine previous policies related to price transparency and the 2-midnight rule, while also asking for comments on how to potentially undo its policy that reduced payments for drugs purchased under the 340B drug discount program by nearly 30%.
CMS recently announced that it updated the national coverage policy for transcatheter aortic valve replacement (TAVR), requiring covered hospitals and physicians to begin or maintain a TAVR program and adhere to updated volume requirements.
