The Centers for Medicare & Medicaid Services (CMS) proposed rule [CMS-1601-P] would update Medicare payment policies and rates for hospital outpatient department and ASC services. The rule would also update and streamline programs that encourage high-quality care in outpatient settings consistent with policies included in the Affordable Care Act. Some of the guidelines of the rule are:
- CMS proposes to update the OPPS market basket by 1.8 percent for CY 2014.
- For 2014, CMS proposes to package seven new categories of supporting items and services. For many of these services, the OPPS will continue to make a separate payment if they are reported alone on a claim.
- CMS proposes to update the two payment rates for community mental health centers and the two payment rates for hospital-based PHPs.
- CMS is proposing five new measures for the OQR program, affecting payment in CY 2016, with data collection beginning in CY 2014 while also proposing to remove two measures: (OP-19)/(OP-24)
The proposed payment system would reduce unnecessary procedures and remove opportunities for up-coding.
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