End the duopoly

CMS proposes eliminating inpatient-only list


Brian Tucker / Healthcare Dive Dive Brief:

CMS is proposing to eliminate the list of services that can be done on an inpatient-only basis for Medicare patients over the next three years, beginning by removing about 300 musculoskeletal-related services, according to proposed rulemaking out Monday evening.

It is seeking comment on whether three years is enough time to make the transition and in what order services should be removed.

Also in the Outpatient Prospective Payment System proposed rule , outpatient payments to providers will increase 2.6% next year, with overall payments estimated to go up $1.6 billion from this year.

That’s larger than the rate increase the Medicare Payment Advisory Commission suggested in its March report to Congress .

The proposed rule retains a nearly 30% cut to payment of certain drugs for 340B hospitals, following a Friday decision by the U.S. Court of Appeals for the District of Columbia upholding the rate reduction despite a challenge from hospital groups.

It also continues a legally disputed policy of site-neutral payments.

Dive Insight:

The outpatient payment rule, if finalized, would continue a move of care away from the hospital setting by eliminating the requirement that hundreds of services […]

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