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

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

Latest posts by John Verhovshek (see all)

Read the complete Article

Login as a member or sign up for free to get uninterrupted access to AAPC blog posts and stay updated on industry news through our monthly newsletter.

2017-code-book-bundles-728x90-01

About Has 432 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.

Leave a Reply

Your email address will not be published. Required fields are marked *