Dive Brief:
- CMS on July 3 proposed a 2.1% pay hike above the 2014 rate starting Jan. 1 for hospital outpatient services; ambulatory surgical centers would get a 1.2% pay boost for 2015.
- The federal agency also seeks to bundle payments for ancillary services. CMS proposed implementing its 2014 final rule creating 28 comprehensive ambulatory payment classifications (APCs) to handle Medicare payments for the costliest device-dependent services.
- CMS clarified that admission orders are a condition of payment for all inpatient hospital admissions, but it will require formal physician certification only for long-stay cases of 20 days or more and for outlier cases.
Dive Insight:
CMS released its proposed 2015 rates for Medicare's Outpatient Prospective Payment System (OPPS), along with various proposed policy changes, on the afternoon prior to the long July 4th weekend. That left scant time for provider groups to react to the operational and financial impact that Medicare's new policies could have on hospitals if finalized. CMS's latest proposal highlights a trend toward discouraging unnecessary hospital admissions; it already has proposed cutting payments for admissions at hospitals by about $241 million in 2015, partly due to the Affordable Care Act. CMS's 687-page proposed rule will run July 14 in The Federal Register; public comments are due Sept. 2.
