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CMS Releases Mid-Build Off-Campus Outpatient Department Audit Results

On January 19, 2021, CMS announced the results of its audit of off-campus outpatient departments claiming the “mid-build” exception following enactment of the 21st Century Cures Act (the Cures Act). Of the 334 providers that...more

CMS Proposes Quality Program Changes, Increased OPPS and ASC Medicare Payments for 2021

On August 4, 2020, CMS proposed its annual rule adjusting the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System, as well as changes to quality reporting...more

Federal Court Says 2018 OPPS 340B Program Rate Cuts Unlawful, Orders Briefing to Avoid ‘Havoc’ on Medicare Program

On December 27, 2018, Judge Rudolph Contreras of the U.S. District Court for the District of Columbia ruled in favor of several associations and hospital plaintiffs, including the American Hospital Association (AHA)...more

CMS Releases Proposed Rule for 2019 Hospital Outpatient Prospective Payment System, Includes Major Proposals on Site Neutrality

On July 25, 2018, CMS proposed a rule (Proposed Rule) revising factors for determining Medicare payment rates for the Hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgery Center (ASC) Payment...more

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