CMS releases OPPS, ASC proposed rule for 2017

Editor's Note

The Centers for Medicare & Medicaid Services (CMS) on July 14 published the 2017 Medicare Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System policy changes, quality provisions, and payment rates proposed rule.

 Among the proposals:

•  an increase in OPPS payment rates by 1.55%--a combination of a positive 2.8% market basket update, a negative 0.5 update for productivity adjustment, and a negative 0.75% update for cuts under the Affordable Care Act
• a stop to paying hospitals’ off-campus facilities the same as hospital-based outpatient departments
• an increase in payment rates for ASCs by 1.2% and hospital outpatient services by 1.6%
• the addition of eight new procedures to the ASC list of payable procedures for 2017, including five codes currently payable in HOPDs and three codes currently on the inpatient-only list. They include spine bone autografts, fixation devices, and prosthetic devices
• a request for public comments on whether total knee arthroplasty should be removed from the inpatient-only list
• an elimination of patient satisfaction on pain management from the value-based purchasing program
• a addition of seven measures to the Hospital Quality Reporting Program for the 2020 payment determination and subsequent years.

Comments on the proposed rule will be received until September 6, 2016.