OIG Recommends Reducing Hospital Outpatient Payments to Match ASC Rates

OIG Recommends Reducing Hospital Outpatient Payments to Match ASC Rates

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) has recommended that the Centers for Medicare & Medicaid Services (CMS) reduce outpatient prospective payment system (OPPS) payment rates for ambulatory surgical center-approved procedures on beneficiaries with no-risk or low-risk clinical needs in outpatient departments.

The report “Medicare and Beneficiaries Could Save Billions If CMS Reduces Hospital Outpatient Department Payment Rates for Ambulatory Surgical Center-Approved Procedures to Ambulatory Surgical Center Payment Rates” argues that the change could save Medicare and beneficiaries could save $12 billion during a five-year period if CMS reduces hospital outpatient department payment rates for ambulatory surgical center (ASC)-approved procedures to the same level as ASC payment rates.

Ambulatory Surgical Center CASCC

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John Verhovshek

John Verhovshek

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.
John Verhovshek

About Has 406 Posts

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.

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