HIDA Government Affairs Alert

July 24, 2014

HIDA Summarizes CY2015 Hospital OPPS & ASC Proposed Rules

The HIDA Government Affairs team has reviewed the CY 2015 Prospective Payment System proposed rules from Centers for Medicare & Medicaid Services (CMS) and outlined the important policy takeaways in two new HIDA Summaries:  Hospital Outpatient Prospective Payment System (OPPS) summary and Ambulatory Surgical Centers (ASC) summary.

In the OPPS summary, HIDA explains that the CMS is proposing that hospital outpatient facilities will receive a 1.7% increase in Medicare reimbursement in CY 2015. Key highlights include:

  • Proposed changes to the comprehensive Ambulatory Payment Classification (APC) groups
  • One new measure to the Hospital Outpatient Quality Reporting (OQR) Program in CY 2017
  • Three measures retired for CY 2016
  • Ancillary services of $100 or less packaged together

In the ASC summary, HIDA notes that CMS expects ASCs to receive an overall 1.2% increase in reimbursement payment rates for CY 2015. Key highlights include:

  • One new measure for the ASC Quality Reporting Program for CY 2017
  • ASCs that fail to meet ASCQR Program reporting requirements will receive a 2% reduction to their Medicare reimbursement

CMS is expected to finalize these rules in September, 2014.

Please contact HIDA Government Affairs if you have any questions, hidagovaffairs@hida.org or (703) 549-4432.