In the Nov. 27 Federal Register, CMS published a final rule with comment period revising the Medicare hospital outpatient prospective payment system (OPPS) and making changes to the amounts and factors used to determine the OPPS payment rates in CY08. (This is the official release of the final rule, originally announced on Nov. 1.) The rule also sets forth the applicable relative payment weights and amounts for services furnished in ambulatory surgery centers (ASCs), specific HCPCS codes to which the final policies of the ASC payment system apply, and other pertinent rate-setting information for the CY08 ASC payment system. In addition, the rule will make changes to the policies regarding the necessary provider designations of critical access hospitals and to several of the current conditions of participation requirements.
The agency also changed the provisions in its previously issued FY08 IPPS final rule and has established a new policy, retroactive to Oct. 1, 2007, of not applying the documentation and coding adjustment to the FY08 hospital-specific rates for Medicare-dependent, small rural hospitals and sole community hospitals. One section on which CMS is soliciting comment and is considering “interim final” are the regulations relating to graduate medical education payments made to teaching hospitals that have Medicare affiliation agreements for certain emergency situations. Download the final rule.
