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OPPS


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publication date

Finance
2021 OPPS Final Rule: CMS Moving Forward with Inpatient-only List Elimination, Prior Authorization Expansion
Revenue Cycle Advisor | December 03, 2020
For more information on the 2021 OPPS final rule, including changes to supervision for therapy services and payment rates, see...
Finance
2021 OPPS Proposed Rule: CMS Looks to Eliminate Inpatient-only List, Increase 340B Payment Cuts
Revenue Cycle Advisor | August 05, 2020
The proposed rule also introduces many new codes and status indicator changes that stakeholders need to carefully review carefully to...
Clinical Care
CMS Eliminates Direct Supervision Requirement for Hospitals
Kimberly A. Hoy JD CPC | December 27, 2019
This rule places decisions about supervision in the control of hospitals and physicians involved in patient care and will make...
Finance
'Above the Law'? Judge Criticizes 2020 Rule on Site-Neutral Payments, Lets It Stand
Steven Porter | December 16, 2019
Hospitals had asked the court that vacated the 2019 rule to enforce its decision against the 2020 rule as well....
Finance
Site-Neutral Back Pay: CMS to Give Hospitals More Money for 2019, Carry Fight Into 2020
Steven Porter | December 13, 2019
The administration agreed to comply with a federal judge's order that vacated site-neutral payment provisions of OPPS 2019, but it...
Finance
Site-Neutral Groundhog? Hospitals Urge Judge to Whack 2020 Payment Policy, Too
Steven Porter | November 12, 2019
The government is moving forward with 'the second year of a two-year phase-in,' even though a judge vacated the policy...
Finance
Site-Neutral Payments: Judge Holds Her Ground in Vacating OPPS Provisions
Steven Porter | October 22, 2019
The latest ruling opens the door to a possible appeal by the Trump administration, which has argued it has the...
Strategy
Providers Push Back Against OPPS Price Transparency Proposal
Jack O'Brien | September 30, 2019
The American Hospital Association submitted a 66-page comment to the proposed OPPS changes for 2020.
Strategy
Judge Grants Hospitals Victory in Site-Neutral Payments Dispute
Steven Porter | September 18, 2019
A federal judge vacated the CMS policy, saying the agency overstepped its legal authority in making the payment cut to...
Finance
Hospitals Sue HHS Over Site-Neutral Outpatient Payments
Steven Porter | December 05, 2018
Changes set to take effect next month will result in a significant reimbursement reduction for hospital-owned outpatient departments that would...
Finance
Inpatient or Outpatient? Medicare Rule Sows Knee Replacement Confusion
Alexandra Wilson Pecci | November 08, 2018
Many hospitals are instructing surgeons to schedule all Medicare total knee arthroplasties as outpatient procedures.
Finance
Site-Neutral Payments Finalized Despite Hospitals' Objections
Steven Porter | November 02, 2018
The policy change constitutes a 40% reduction for some hospital outpatient departments.
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