On July 25th, the Centers for Medicare and Medicaid Services (CMS) issued a proposed Hospital Outpatient Prospective Payment System (OPPS) rule that would update Medicare payment rates for hospital outpatient departments and ambulatory surgery centers (ASCs) for CY 2019. The rule would increase OPPS rates by 1.25%. However, proposed changes to off-campus Provider-Based Department payment policies are expected to effectively offset the OPPS rate increase resulting in a net decrease of 0.1% ($80 million nationwide). The rule would increase ASC payment rates by 2.0% or $32 million in 2019.
The rule also makes numerous other changes, including changes to 340B and other drug payments, procedure classifications, and quality measures. The attached document summarizes key payment and policy changes proposed by the rule.
CMS will accept comments on the proposed rule until September 24th. The text of the rule is available here.