Summary of CMS’s Top 5 Proposed Payment Rules, Revisions
By - The Centers for Medicare & Medicaid Services (CMS) has continuously released a steady stream of payment policies and physician fee schedules. As RevCycleIntelligence.com reported in a summary of top 6 previously proposed payment rules and physician fee schedules, financial policy adjustments have been hearty as CMS advances its efforts to reduce unnecessary costs manifest, update payment rates for Medicare services, and amend various conditions across the healthcare industry.
Here is another follow-up summary with 5 more highlights regarding CMS’s proposed rules.
CMS-1631-P
This annual proposed rule pushes for amendments under the Medicare physician fee schedule. Other payment policy changes under Medicare Part B are suggested. All changes within the 282 page document are applicable beginning January 1 of next year. This major proposed rule, says CMS, ensures payment systems are updated to reflect medical practice revisions and to mirror the relative value of services as well as statute changes.
CMS-1633-P
Payment updates for hospices are underway with this proposed rule from CMS which recommends modifications to the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system within the upcoming year. Based on ongoing experience with such systems, the proposed rule defines planned changes to the payment rate amounts and factors that dictate Medicare payment rates under OPPS and ASC. Requirements regarding The Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program would also be restructured.
Proposed changes to the 2-midnight rule, a short inpatient hospital stay policy that once manifested a slow-down in Medicare claims due to delays, is also in CMS’s cards. Additionally proposed is a discussion of the related -.02 percent payment adjustment and a planned transition for Medicare-dependent, rural hospitals.
CMS-1623-N
CMS announces a public meeting occurring this week on July 16, 2015. The purpose of such is to receive commentary and recommendations from the public about how to best establish payment amounts for the Healthcare Common Procedure Coding System (HCPCS). HCPSC codes are being assessed according to Medicare payment under next year’s clinical laboratory fee schedule (CLFS).
CMS-1629-P
According to this proposed rule, hospice payment rates and next year’s wage index will be revised. Payments for routine home health care (RHC) based on how long a beneficiary stays in the hospital are to be more clearly defined according to whether or not certain criteria is met. Modifications to the aggregate cap calculation via the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) are also in the works with a goal to match up the cap accounting year for both the inpatient cap and the hospice aggregate cap beginning in 2017. Additional modifications to the hospice quality reporting program are proposed. A hospice claim’s diagnosis reporting will also be more clearly defined.
CMS-3260-P
In this proposed rule from CMS, there will be revisions made to long-term care facilities. Alleged changes mirror various recent advances to strengthen the delivery and safety of various healthcare services. Healthcare providers will in turn experience lessened procedural burdens, says CMS.
