CMS proposes policy, payment changes for ambulatory surgical centers, outpatient care in hospitals

The Centers for Medicare & Medicaid Services issued a proposed rule that would update payment policies and payment rates furnished to Medicare beneficiaries in hospital outpatient departments and ambulatory surgical centers.

The change, according to a Centers for Medicare & Medicaid Services (CMS) news release, would begin Jan. 1, 2013, and impact approximately 5,000 Medicare-participating ambulatory surgical centers (ASCs) and hospital outpatient departments (HOPDs) in more than 4,000 hospitals.

“The policies and payment rates included in the proposed rule are intended to ensure that beneficiaries have access to high quality care in the outpatient setting,” CMS deputy administrator Jonathan Blum stated in the release.

ASC payment rates would increase 1.3%, according to the proposed rule, with HOPD payment rates increasing 2.1%. The 1.3% increase in ASC payment rates, the release noted, matches the projected inflation rate of 2.2% minus a 0.9% adjustment required by law for productivity improvements. CMS projected that payments to ASCs under the ASC Payment System will be approximately $4.1 billion.

CMS is asking for public comment on potential data that Medicare could collect to develop an inflation index that would explicitly measure ASC cost growth.

Quality reporting programs for ASCs also stand to change under the proposed rule, with CMS proposing revisions to procedural requirements applying to the reporting of quality data, a policy for updating measures, data completeness requirements and a methodology for the reduction of payments to ASCs that fail to meet the ASC Quality Reporting Program reporting requirements.

According to the release, the proposed rule will appear in the July 30 Federal Register. CMS will accept comments on the proposed rule until Sept. 4, and will respond to all comments in a final rule to be issued by Nov. 1.

Reference:

www.cms.gov