On July 29th, CMS released two proposed Medicare 2020 payment rules: the Physician Fee Schedule (PFS), and the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System. On August 2nd, CMS released a final 2020 payment rule, the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule. Together these rules set parameters for a large majority of original Medicare reimbursements, including fee schedules and incentive programs.
Selected changes of note:
- Proposed creation of the MIPS Value Pathways program to prepare all MIPS clinicians for Advanced APMs (PFS);
- Proposal to make public all hospital charges, including charges negotiated with payers, and to publicly post consumer-friendly episode-based charge information for 300 “shoppable” services (OPPS); and
- Final Wage Index rule changes, and final changes to various measures and penalties for the Hospital-Acquired Infection Reduction Program, Hospital Readmission Reduction Program, Inpatient Quality Reporting Program and Promoting Interoperability Program (IPPS).
Summaries of the proposed rules and the final rule are attached (PFS, OPPS/ASC, and LTCH PPS). The complete rules can be found here, here, and here.