The Centers for Medicare & Medicaid Services’ (CMS) 2014 proposed rules for the hospital outpatient prospective system (OPPS), released earlier this week, offer payment increases and “packaging” of services.
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The proposed rule would increase hospital OPPS payments by $4.37 billion or 9.5 percent, and 2014 Medicare payments to ambulatory surgical centers (ASCs) by approximately $133 million or 3.51 percent, as compared to 2013, according to a CMS press release.
In its effort to continue streamlining the payment system, CMS proposes to “package” particular services and supports into seven new categories. A separate payment would still be made if an item included in a package is reported alone on a claim.
CMS also proposes collapsing the current five levels of outpatient visit codes to one. CMS believes this option “… will remove incentives hospitals may have to provide medically unnecessary services or expend additional, unnecessary resources to achieve a higher level of visit payment under the OPPS, will reduce administrative burden and be easily adopted by hospitals, and will allow a large universe of claims to be utilized for rate setting,” the agency said in its press release.
The rule also proposes to end the direct supervision enforcement delay for critical access hospitals and small rural hospitals on Dec. 31 and create 29 comprehensive ambulatory payment classifications to replace existing device-dependent APCs.
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Comments are due to CMS by Sept. 6 and final rules are expected by Nov. 1, according to the press release. The proposed rule is scheduled to appear in the Federal Register on July 19.
[See also: Proposed CMS rule would increase net acute-care hospital pay by 0.9 percent]