CMS releases proposed 2009 outpatient/ASC rule

The Centers for Medicare & Medicaid Services on July 3 released a proposed rule updating Medicare payment rates for hospital outpatient and ambulatory surgery center services for calendar year 2009. According to the rule, CMS would continue to transition to the new ASC payment rates, with ASC services paid at a 50/50 blend of the 2007 ASC payment and the 2009 ASC payment, which are 65% of the hospital outpatient rate.

Hospitals reporting seven outpatient quality measures in 2009 would receive a 3.0% inflation update, while eligible hospitals not submitting data would receive a 1.0% update. The proposed rule outlines the process for validating hospitals’ quality data; proposes adding four new imaging efficiency quality measures for public reporting in order to receive a full update in CY 2010; and seeks comment on 18 other quality measures for potential inclusion at a future date.

It also would alter how CMS pays for imaging services when multiple services are provided in one session, by creating a single payment for certain multiple imaging services such as ultrasound, computed tomography and magnetic resonance imaging. The rule also changes the way partial hospitalization services are paid, reduces payments for separately payable drugs, and proposes changes to the hospital Medicare cost report for drugs and biologicals.

The rule will appear in the July 18 Federal Register, with comments accepted until Sept. 2. 

[ via AHA News Now ]