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CMS proposes payment changes for ambulatory surgical centers
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The Centers for Medicare & Medicaid Services has issued a proposed rule that would update payment policies and rates for services furnished to Medicare beneficiaries in hospital outpatient departments and ambulatory surgical centers starting next calendar year.
The rule, according to a Centers for Medicare & Medicaid Services (CMS) release, helps emphasize the importance of beneficiaries being able to receive quality care without regard to the care setting.
“The CMS is committed to using every tool at its disposal to create incentives that will improve the quality and safety of care received by Medicare beneficiaries, wherever that care is provided,” CMS Administrator Donald M. Berwick, MD, stated in the release.
Contained in the rule are proposals the CMS stated would strengthen the Hospital Value-Based Purchasing program required by the Affordable Care Act of 2010. The program — established through a CMS final rule in April of this year — ties a portion of a hospital’s payment for inpatient stays under the Inpatient Prospective Payment System in the 2014 fiscal year to performance score on a set of quality measures.
Other proposals include:
- changes to the Medicare Electronic Health Record Incentive Program that allow eligible hospitals to report clinical quality measures for 2012 by participating in an electronic reporting pilot;
- strengthening of the Hospital Outpatient Quality Reporting Program, as well as the establishment of a quality reporting program for ambulatory surgical centers (ASCs); and
- implementation of Affordable Care Act provisions affecting the expansion of physician-owned hospitals, which would allow certain physician-owned hospitals to apply for an exception to the prohibition on expansion of facility capacity.
The CMS projected that total payments to more than 4,000 hospitals under the Outpatient Prospective Payment System in 2012 will be around $41.9 billion. The agency also projected payments to approximately 5,000 Medicare-participating ASCs under the ASC Payment System will be around $3.61 billion.
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