News: CMS releases 2018 OPPS proposed rule

CMS released the 2018 Outpatient Prospective Payment System (OPPS) proposed rule last week on Thursday, July 13. With CDI programs increasingly looking at outpatient records, the need to read and digest the OPPS proposed rule has never been greater. This particular proposed rule, however, affects all hospitals, according to Revenue Cycle Advisor.  

Though the rule is significantly shorter than in previous years, “[w]hat’s clear is this rule packs a punch, so no one should be misled by how short it is,” Jugna Shah, MPH, president and founder of Nimitt Consulting told Revenue Cycle Advisor. “There are several significant proposals [healthcare providers] will need to pay attention to and comment on to CMS.”

One such change is CMS’ expansion of the packaging policies. This move, according to Shah, is not surprising as CMS has been moving the OPPS in the direction of bundled payments for quite some time now.

For 2018, CMS proposes conditionally packaging a number of CPT/HCPCS codes associated with two Ambulatory Payment Classifications when reported with other separately payable services, but will still pay for them when performed alone, Revenue Cycle Advisor reported.

As with all the CMS proposed rules, CMS requests general feedback on methods for improving the programs’ efficiency and flexibility to reduce administrative burden, but CMS is also looking for more proposal-specific feedback as well. Comments are due Monday, September 11.

Editor’s note: To see the proposed rule fact sheet, click here. To read the accompanying press release, click here. To read the complete statement from the AHA, click here. To read about the 2018 IPPS proposed rule, click here.