The update will be reduced by 2.0 percentage points for hospitals that did not participate in quality data reporting for outpatient services or did not report the quality data successfully, resulting in a 0.1 percent update for those hospitals, according to the release.
The payment updates are included in a final rule with comment period that revises payment policies and updates the payment rates for services furnished to beneficiaries during calendar year 2010 in hospital outpatient departments under the Outpatient Prospective Payment System, according to the release.
Under the rule, hospitals will be able to bill Medicare for new pulmonary and intensive cardiac rehabilitation services furnished in hospital outpatient departments to Medicare beneficiaries as of Jan. 1, 2010. Rural hospitals will also receive payment for kidney disease education services furnished in outpatient departments to Medicare beneficiaries with Stage IV chronic kidney disease.
A payment adjustment for the hospital pharmacy overhead costs of separately payable drugs and biologicals is also included in the rule and better recognizes the overhead costs for these drugs and biologicals relative to those for drugs and biologicals that are packaged into Medicare’s payment for the associated ambulatory payment classification, according to the release.
Hospitals participating in the Hospital Outpatient Department Quality Data Reporting Program will be required by CMS to report the existing seven emergency department and perioperative care measures, as well as the four existing claims-based imaging efficiency measures for the CY 2011 payment determination, according to the release. CMS also will phase in a new HOP QDRP validation requirement to ensure that hospitals are accurately reporting measures for chart-abstracted data.
The CY 2010 OPPS final rule with comment period will appear in the Nov. 20 Federal Register. Comments on designated provisions are due by 5:00 p.m. EST on Dec. 29, 2009. CMS will respond to comments in the CY 2011 OPPS final rule.
For more information on the CY 2010 OPPS final rule, click here.
Read the release about CMS’s CY 2010 OPPS final rule.
