On July 29, 2019, the Centers for Medicare and Medicaid Services (CMS) released proposed updates to payment rates and regulations applicable to the Hospital Outpatient Prospective Payment System (OPPS) and updated payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS). Most of CMS’s proposals would take effect January 1, 2020.
Four key components of the proposed rules include:
Requiring hospitals to disclose negotiated rates with third-party payers;
Extending reimbursement cuts for 340B drugs through 2020;
Reducing the supervision requirement for outpatient hospital therapeutic services from direct supervision to general supervision; and
Establishing a prior authorization requirement for five categories of procedures.
Advis President and CEO, Lyndean Brick, and members of the Advis leadership team, provide insightful forecasts on how they see the new rules affecting the future of healthcare.