This week’s Medicare updates include two new advisory opinions; updates to the Physician Compare, Long-Term Care Hospital Compare, and Inpatient Rehabilitation Facility Compare websites; a republished version of the OPPS final rule to include a previously omitted section, and more!
The 2018 OPPS final rule, published in the Federal Register on November 13, has two changes that could affect case managers—the removal of the total knee replacement from the inpatient-only list and cuts to payments for drugs purchased through the 340B drug discount program.
Effective January 1, 2018, Medicare payments for X-rays taken using computed radiography will be reduced by 7%, according to a policy CMS finalized in the 2018 OPPS final rule. This reduction will remain effective until 2022, and increase to 10% beginning in 2023, as required by paragraph 1848 (b)(9) of the Social Security Act.
CMS is moving forward with its plan to drastically cut payments for drugs acquired through the 340B drug discount program, according to the 2018 OPPS final rule, released in November.
CMS’ policy in the 2018 OPPS final rule to cut reimbursement for drugs purchased through the 340B drug discount program by nearly 30%, accounting for the decrease from average sales price plus 6% to minus 22.5%, is getting a lot of attention from the provider community—and with good reason.
A Comprehensive Error Rate Testing (CERT) study showed insufficient documentation causes most improper payments for arthroscopic rotator cuff repairs, according to the October 2017 Medicare Quarterly Compliance Newsletter.
