CMS Issues Correction to OPPS Final Rule, Payments Decrease 0.1%

CMS recently issued a correction (pdf) to its Hospital Outpatient Prospective Payment system for calendar year 2012 that will change the estimated increase for all facilities and hospitals from 1.9 percent to 1.8 percent.

The decline in payment rates resulted from the CY 2011 threshold models that were paying "1 percent of total payment for outliers rather than 0.93 percent. Therefore, the estimated total increase in payment based on the technical corrections…results in a decline of 0.1 percent."

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Furthermore, CMS used an incorrect set of claims data in establishing the median costs. The fixed-dollar outlier for CY 2012 was changed from $1,900 to $2,025.

Table 59, which listed the estimated impact of the changes for the hospital OPPS, was also updated. CMS removed a hospital that had submitted a claim containing a single line for which no payment was made. The total number of hospitals represented in the OPPS data is now 3,894 instead of 3,895.

Related Articles on CMS Final Rules:

Hospital Outpatient Payments to Increase 1.9% in Final OPPS Rule

CMS Releases Physician Fee Schedule, Includes 27.4% Cut to Physician Payments

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

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