CMS has published the Proposed 2020 Medicare Outpatient Prospective Payment Rule. The deadline for comment is September 27, 2019. The Proposed Rule contains a number of notable items including:
- Establishment of a 1-year exemption from patient status denials and referrals to RACs for procedures that are removed from the inpatient only list.
- Removal of total hip arthroplasty from the inpatient only list.
- Updated requirements for hospital charge transparency to mandate hospitals post standard charges in two separate, searchable “consumer-friendly” ways with penalties for non-compliance.
- Adoption of the physician fee schedule payment rates for clinic visit services provided in excepted off-campus provider-based departments.
- The Proposal is also seeking comments related to potential date of service reporting requirements for laboratory services.
- No changes to payment status indicators.
- No changes to quality measures.
The Proposed Rule includes many other important issues. We recommend you read the completed Proposed Rule to understand the changes and impact to your facility.