Outpatient Prospective Payment Systems (OPPS)
CMS generally makes payment for hospital outpatient department services through the Hospital Outpatient Prospective Payment System (OPPS).
On July 25, the Centers for Medicare & Medicaid Services (CMS) issued its CY 2019 outpatient prospective payment system/ambulatory surgical center proposed rule. In addition to standard updates, the rule would substantially expand Medicare site-neutral payment policies in several areas and make…
Comparison between CY 2019 OPPS proposed rule and CY 2018 relative weights and payment rates at the APC level, using CMS’s Addendum A
This excel spreadsheet compares relative weights and payment rates at the APC level, using the CY 2019 OPPS proposed rule Addendum A compared to CY 2018…
AHA Special Bulletin that highlights the Centers for Medicare & Medicaid Services' calendar year 2019 outpatient prospective payment system/ambulatory surgical center proposed rule.
The Centers for Medicare & Medicaid Services today proposed to update hospital outpatient prospective payment system rates by 1.25% in calendar year 2019 compared to CY 2018.
Plaintiffs’ notice of supplemental authority (ECF No. 78) asserts that HHS could reduce the Medicare appeals backlog by agreeing to toll the purported deadline for hospitals to file appeals related to the 340B Drug Discount Program pending the resolution of American Hospital Association v. Azar, No…
Plaintiffs-Appellants, three hospital associations and three hospital systems, move to expedite this appeal from an order dismissing Appellants' complaint and denying a preliminary injunction that would have suspended implementation on January 1, 2018, of a new HHS rule drastically reducing payment…
The Centers for Medicare & Medicaid Services (CMS) July 10 released its calendar year (CY) 2025 outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) proposed rule. The rule would increase OPPS rates by a net 2.6% in CY 2025 compared to CY 2024. CMS…
For 25 years, the 340B drug savings program, at no cost to the government, has enabled eligible hospitals to purchase certain outpatient drugs from pharmaceutical manufacturers at discounted prices. This allows the participating hospitals to use the savings from the discounts to provide an expanded…