CMS Finalizes Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Changes for 2019

PUBLISHED: Nov 5, 2018
Relevant to: Ambulatory Care, Critical Access Hospitals, Hospitals

The U.S. Centers for Medicare and Medicaid Services (CMS) has issued its final rule, with comment period, that updates and revises policies under the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgical Center (ASC) Payment System.

The final rule contains a number of policies that reduce payment differences between hospitals and ambulatory surgical centers so that patients may better benefit from high quality care at lower costs, while receiving care that is provided safely and is clinically appropriate.

The final rule also updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program. CMS is also updating the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey measure under the Hospital Inpatient Quality Reporting (IQR) Program by removing the Communication about Pain questions; and retaining two measures that were proposed for removal, the Catheter-Associated Urinary Tract Infection (CAUTI) Outcome Measure and Central Line-Associated Bloodstream Infection (CLABSI) Outcome Measure, in the PPS-Exempt Cancer Hospital Quality Reporting (PCHQR) Program beginning with the FY 2021 program year.

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