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.
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