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Outpatient Prospective Payment System (OPPS)

The lawsuit argues that the 340B provisions of the Centers for Medicare & Medicaid Services’ outpatient prospective payment system rule violate the Social Security Act and should be set aside under the Administrative Procedure Act as unlawful and in excess of the HHS Secretary’s statutory authority.

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Outpatient Prospective Payment System (OPPS)

America’s Essential Hospitals is closely reviewing the final rules and pursuing strategies to protect our members from these devastating cuts. Key aspects of the recently released final rules are summarized in this Action Update.

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Outpatient Prospective Payment System (OPPS)

Dive into the policy details of the CMS rule that cuts 340B program savings, and hear how America’s Essential Hospitals plans to respond.

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Outpatient Prospective Payment System (OPPS)

The rule cuts 340B Drug Pricing Program payments by $1.6 billion and requires hospitals to use modifiers to identify 340B drugs in Medicare claims.

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Outpatient Prospective Payment System (OPPS)

The final rule's cuts to Medicare Part B drug payments to 340B hospitals jeopardizes health care access for millions of low-income individuals and families nationwide and weakens the ability of essential hospitals to provide vital services to communities.

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Outpatient Prospective Payment System (OPPS)

The harmful payment reduction was included in the 2018 Outpatient Prospective Payment System proposed rule, expected to be finalized this fall.

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Outpatient Prospective Payment System (OPPS)

Unless another delay is secured, Medicaid disproportionate share hospital payments will be cut by $2 billion beginning in fiscal year 2018, escalating to $8 billion by 2024.

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Outpatient Prospective Payment System (OPPS)

The meeting came a day after the association submitted comments to the agency in response to the proposed annual update of the Hospital Outpatient Prospective Payment System.

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Outpatient Prospective Payment System (OPPS)

The proposed rule would further cut payments to non-excepted provider-based departments to 25 percent of the Medicare Outpatient Prospective Payment System rate and change certain quality reporting requirements.

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Outpatient Prospective Payment System (OPPS)

By cutting reimbursement rates for Part B drugs to 340B hospitals, the Centers for Medicare & Medicaid Services would harm essential hospitals, which care for the nation’s poorest, most complex, and costliest patients.

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Outpatient Prospective Payment System (OPPS)

The latest from experts on the CMS proposed policy rules that cut 340B savings and support for outpatient services in underserved areas.

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Outpatient Prospective Payment System (OPPS)

Proposed rules would affect outpatient payment rates, reduce Medicare Part B payments to hospitals in the 340B Program, and revise site-neutral policies.

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Outpatient Prospective Payment System (OPPS)

The Medicare Physician Fee Schedule proposed rule for calendar year 2018 includes physician payment and quality program changes.

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Outpatient Prospective Payment System (OPPS)

The proposed rule would increase outpatient payment rates by 1.75 percent and drastically reduce Medicare Part B reimbursement for drugs purchased through the 340B Drug Pricing Program.

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Outpatient Prospective Payment System (OPPS)

The policy team at America's Essential Hospitals discussed the regulatory outlook for the next year, including key policy issues on the horizon.

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Outpatient Prospective Payment System (OPPS)

Essential hospitals can expect the new Congress' Republican leaders to follow through quickly with their pledge to repeal the Affordable Care Act.

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Outpatient Prospective Payment System (OPPS)

A CMS spokesperson said the project was pulled after the agency reviewed public comments — there were more than 1,300 comments submitted, mostly negative.

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Outpatient Prospective Payment System (OPPS)

The legislation, expected to quickly receive the president's signature, includes two key advocacy goals for the association: risk adjustment of the Hospital Readmissions Reduction Program and partial relief from hospital outpatient department payment cuts.

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Outpatient Prospective Payment System (OPPS)

Congress is poised to pass legislation that would include socioeconomic risk adjustment for the Hospital Readmissions Reduction Program and some relief from payment cuts for new hospital outpatient departments.

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Outpatient Prospective Payment System (OPPS)

Under the rule, CMS would increase the OPPS payment rate by 1.65 percent and provide flexibility in the meaningful use of EHRs, among other things.

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Outpatient Prospective Payment System (OPPS)

Join us to discuss the policies, outlined by CMS, for the implementation of the site neutral law.

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Outpatient Prospective Payment System (OPPS)

CMS provides more flexibility than previously proposed, ensuring non-grandfathered, off-campus hospital outpatient departments will be reimbursed in 2017.

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Outpatient Prospective Payment System (OPPS)

In the rule, CMS revised its earlier position not to direct any physician fee schedule payments to non-grandfathered, off-campus hospital clinics in 2017 and, instead, established a 50 percent interim rate.

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Outpatient Prospective Payment System (OPPS)

While the final rule provides some relief from onerous proposed payment policies, it continues to put underserved communities at risk of further declines in access to care, the association says.

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Outpatient Prospective Payment System (OPPS)

CMS recently proposed policies for implementing the site neutral law – join us July 26 to discuss the impacts this will have on your hospital.

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Outpatient Prospective Payment System (OPPS)

The proposed rule updates the payment rate for services provided in hospital outpatient departments and provisions relating to quality reporting.

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Outpatient Prospective Payment System (OPPS)

The proposed rule would implement Section 603 of the Bipartisan Budget Act, which reduced payments for new, off-campus hospital outpatient departments.

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Outpatient Prospective Payment System (OPPS)

America's Essential Hospitals denounces the Centers for Medicare & Medicaid Services decision to limit flexibility and withhold hospital payments for new, off-campus hospital outpatient departments.

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Outpatient Prospective Payment System (OPPS)

A 2015 budget law that creates site-neutral payment for off-campus hospital outpatient departments does not directly affect 340B Drug Pricing Program eligibility, but changes to how hospitals report Medicare costs does raise concerns.

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Outpatient Prospective Payment System (OPPS)

In letter to CMS, association raises issues of payment, definition of off-campus outpatient department of a provider, and 340B eligibility.

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Outpatient Prospective Payment System (OPPS)

Changes include reducing OPPS payment by 0.3 percent, relaxing two-midnight policy requirements, and updating OQR measures.

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Outpatient Prospective Payment System (OPPS)

In comments on the CY 2016 OPPS proposed rule, the association calls on CMS to consider the unique challenges of caring for the most vulnerable, including in relation to the two-midnight policy and ambulatory payment classification.

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Outpatient Prospective Payment System (OPPS)

RACs will not conduct postpayment reviews of patient status for Medicare claims with an inpatient admission between Oct. 1 and Dec. 31, 2015.

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Outpatient Prospective Payment System (OPPS)

Agency proposes to reduce slightly payment rates for hospital outpatient services, relax some provisions of the two-midnight policy, and update quality reporting measures.

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Outpatient Prospective Payment System (OPPS)

In a new policy brief, America's Essential Hospitals describes how billions of dollars in reductions to Medicaid and Medicare funding threaten care at essential hospitals.

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Outpatient Prospective Payment System (OPPS)

Topics of member interest include payment updates, the OQR Program, and the MSSP.

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Outpatient Prospective Payment System (OPPS)

The rules, released Oct. 31, finalized a number of provisions regarding payments, data collection in outpatient departments, quality programs, and the MSSP.

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Outpatient Prospective Payment System (OPPS)

The association urged CMS to revise its C-APC proposal and opposed its proposal to add a claims-based modifier for every outpatient service provided in off-campus provider-based departments.

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Outpatient Prospective Payment System (OPPS)

The agency proposes to increase payment rates by an outpatient department fee schedule increase factor of 2.1 percent for CY 2015. CMS also proposes to collect data on services provided in off-campus provider-based departments by requiring hospitals and physicians to identify these services using a modifier on hospital and physician claims.

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Outpatient Prospective Payment System (OPPS)

CMS released the rule July 3. The agency proposes to increase payment rates by an outpatient department fee schedule increase factor of 2.1 percent for CY 2015. In addition, CMS proposes to collect data on services provided in off-campus provider-based departments by requiring hospitals and physicians to identify these services using a modifier on hospital and physician claims.

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Outpatient Prospective Payment System (OPPS)

The measure, OP-31/ASC-11, is part of the ASC Quality Reporting Program and the OQR Program. Data collection, which was scheduled to begin April 1, will now begin Jan. 1, 2015. America's Essential Hospitals successfully encouraged CMS to delay the measure, arguing the measure was not properly tested for the ASC and outpatient settings.

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Outpatient Prospective Payment System (OPPS)

Voted unanimously to recommend Congress increase Medicare payments rates for FY 2015 OPPS

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Outpatient Prospective Payment System (OPPS)

The rule replaces outpatient visit codes with a single code describing all clinic visits

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Outpatient Prospective Payment System (OPPS)

On November 27, the Centers for Medicare & Medicaid Services (CMS) issued the Outpatient Prospective Payment System (OPPS) final rule for calendar year (CY) 2014. Included in the rule are provisions related to the following: payment for hospital outpatient visits data collection in off-campus, provider-based departments Hospital Outpatient Quality Reporting (OQR) Program Hospital Value-Based Purchasing

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Outpatient Prospective Payment System (OPPS)

Rule finalizes several Outpatient Prospective Payment System provisions

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Outpatient Prospective Payment System (OPPS)

OPPS is used by CMS for hospital outpatient services under Medicare

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Outpatient Prospective Payment System (OPPS)

The final rule was delayed due to the partial government shutdown

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Outpatient Prospective Payment System (OPPS)
Outpatient Prospective Payment System (OPPS)

Suggests CMS convene hospital industry work group to better understand off-campus outpatient care

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Outpatient Prospective Payment System (OPPS)

Rule proposes several outpatient prospective payment system provisions

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Outpatient Prospective Payment System (OPPS)

Agency seeks to understand type and frequency of, and payment for, services furnished in off-campus outpatient departments

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Outpatient Prospective Payment System (OPPS)

Commissioners vote unanimously to recommend 1 percent increases for fiscal year 2014

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About America’s Essential Hospitals

America’s Essential Hospitals is the leading association and champion for hospitals and health systems dedicated to high-quality care for all, including the most vulnerable. Since 1981, America’s Essential Hospitals has initiated, advanced, and preserved programs and policies that help these hospitals ensure access to care. We support members with advocacy, policy development, research, and education.