The Centers for Medicare and Medicaid Services (CMS) on July 3 issued a proposed rule intended to update payment rates for CY09 and improve quality of services provided in hospital outpatient departments and ambulatory surgical centers (ASCs). The rule includes a 3.0 percent annual inflation update to Medicare payment rates for most services that would be paid under the outpatient prospective payment system (OPPS) to more than 4,000 hospitals and community mental health centers in CY09. The proposed changes would affect outpatient services furnished by general acute care hospitals, inpatient rehabilitation facilities, inpatient psychiatric facilities, long-term acute care hospitals, community mental health centers, children’s hospitals, and cancer hospitals. CMS projects that hospitals would receive $28.7 billion in CY09 for outpatient services furnished to Medicare beneficiaries. Furthermore, CMS expects to make payments of almost $3.9 billion in CY09 to the approximately 5,300 ASCs that participate in Medicare.
To receive the full OPPS payment update for services furnished in CY09, hospitals must report data in CY08 on seven quality measures of emergency department and perioperative surgical care. CMS is proposing to add four new measures of imaging efficiency to the seven existing quality measures for purposes of the CY10 update, and is also seeking public comment on 18 additional potential quality measures in areas ranging from screening for fall risk to cancer care.
Comments on the proposed rule will be accepted until Sept. 2, 2008, and a final CY09 OPPS/ASC payment rule will be issued by Nov. 1, 2008. Read the press release.
