CMS finalizes updated payment rates, policy changes affecting OPPS and ASCs

The Centers for Medicare and Medicaid Services has issued a final rule with comment period that updates payment rates and makes policy changes that affect the Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center payment system for 2017.

The updates in the final rule may increase OPPS payments by 1.7% and ASC rates by 1.9% in 2017, according to an agency press release.

New quality measures will be added to the OPPS and ASC quality reporting program to improve patient outcomes and experience of care. CMS considered approximately 3,000 public comments on the proposed rule.

To address physicians’ and health care providers’ concerns, CMS is finalizing the removal of the pain management dimension for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey for the Hospital Value-Based Purchasing Program. According to the CMS press release, this will eliminate financial pressure clinicians may feel to overprescribe medications.

Additionally, CMS is finalizing the implementation of section 603 of the Bipartisan Budget Act of 2015. This section of the budget will require that certain items and services furnished by certain off-campus hospital outpatient departments will no longer be paid under the OPPS beginning Jan. 1, 2017.

The organization will also implement a 90-day reporting period for 2016 and 2017 to support physicians and other eligible providers who participate in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs in order to provide some flexibility in reporting.

Comment period ends Dec. 31, 2016.

Reference:

https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-11-01-3.html