CMS did not change the logic for comprehensive APCs (C-APC) or complexity adjustments in the 2016 OPPS final rule, but did add 10 new C-APCs for 2016 in addition to the 25 established for the first time for 2015.
CMS finalized its proposals regarding the 2-midnight rule, including moving responsibility for rule enforcement and education from Recovery Auditors to Quality Improvement Organizations (QIO). This latter change occurred October 1, 2015.
The 2016 OPPS final rule includes the first negative payment update for the system, but CMS also listened to commenters' suggestions to make a variety of proposals less onerous either operationally or financially.
This week’s updates include Advance Care Planning (ACP) as an optional element of an Annual Wellness Visit (AWV); a request for information regarding the awarding and the administration of MAC contracts; and more!
This week’s updates include calendar year (CY) 2016 annual clinical laboratory fee schedule and laboratory services subject to reasonable charge payment update; Settlement effectuation instructions for HHS Office of Medicare Hearings and Appeals (OMHA) Settlement Conference Facilitation (SCF) Pilot; and more!
Small tweaks to the 2-midnight rule in the 2016 OPPS final rule should help providers, but a lengthy court battle related to the rule could end up making a bad situation worse.
