CMS OPPS Final Rule Includes Minor Changes to Rules for Physician-Owned Hospitals

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CMS' final rule on hospital outpatient prospective payments include a number of minor changes relevant to physician-owned hospitals.

The final rule principally modifies the process through which physician-owned hospitals can apply for an exception to prohibited expansion of facility capacity, which is required under the healthcare reform law. For instance, under the proposed rule physician-owned hospitals would have been required to provide information regarding baseline number of operating rooms, procedure rooms and beds and requested capacity increases to CMS in order to obtain an exception to the prohibition of facility expansions.

In addition, the physician-owned hospitals would have had to satisfy eligibility criteria for the three previous fiscal years. However, the OPPS final rule modifies that proposed provision so that physician-owned hospitals would only have to provide information and supporting documentation on eligibility criteria for the most recent fiscal year.

The OPPS final rule also prohibits physician-owned hospitals and physicians practicing at the hospital from discriminating against beneficiaries of federal healthcare programs. Other changes to the OPPS final rule relating to physician-owned hospitals can be found here.

CMS believes most physician-owned hospitals will be minimally affected by these changes.

Related Articles on Payments:

Hospital Outpatient Payments to Increase 1.9% in Final OPPS Rule
CMS Releases Physician Fee Schedule, Includes 27.4% Cut to Physician Payments
AHA Submits Comments on 2012 Physician Fee Schedule, OPPS

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