2002 Medicare Outpatient
PPS Rule Published
March 8, 2002 - The Centers for Medicare and Medicaid
Services (CMS) March 1 published the long-awaited correction
notice [67
Federal Register 9555] that contains the 2002 payment
rates for the Medicare outpatient prospective payment system
(OPPS). The rule, effective April 1, 2002, addresses errors
in the payment rates that were published Nov. 30, 2001 [66
Federal Register 59855].
The 2002 payment rates were originally scheduled to take
effect Jan. 1, 2002. However, CMS decided to postpone implementation
in response to pressure by the AAMC and other hospital organizations
that questioned the validity of the payment rates, as well
as administrative burdens associated with implementing changes
that had only been published a month before Jan. 1, 2002 [see
Washington Highlights, Dec. 21, 2001]. During the
delay period, hospitals are paid at 2001 rates.
According to the March 1 publication, 13 ambulatory payment
classification (APC) groups will see significant payment changes
from the Nov. 30 rule. These APCs contained procedures that
involved the use of devices. In addition, as a result of payment
recalculation, CMS has determined that the "pro rata"
reduction that will be applied to drugs and devices that qualify
for pass through payments will be 63.6 percent. This reduction,
however will only be applied to payments beginning April 1
through the end of the year. Without the delay, payment reductions
would have occurred effective Jan. 1.
Information:
Karen Fisher, Sr. Director, Health Care Affairs
AAMC Health Care Affairs
kfisher@aamc.org
(202) 862-6140
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