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Outpatient Prospective Payment System (OPPS) Price Transparency

King & Spalding

CMS Updates Hospital Price Transparency FAQs After CY 2024 OPPS/ASC Final Rule

King & Spalding on

CMS’s Hospital Price Transparency regulations require hospitals to make public the standard charges of the items and services that they provide. In the CY 2024 Hospital Outpatient Prospective Payment System Final Rule (CY...more

Nelson Mullins Riley & Scarborough LLP

Expanded Behavioral Health Access, Enhanced Price Transparency, and the 340B Remedy in the CY 2024 Hospital Outpatient and...

The Centers for Medicare & Medicaid Services (CMS) has announced new measures to enhance access to behavioral health services for Medicare beneficiaries and improve hospital price transparency as part of the final rule for...more

King & Spalding

CMS Updates Hospital Price Transparency Technical Implementation Guide

King & Spalding on

Last week, CMS updated its technical implementation guide to the machine-readable file, a requirement of the Hospital Price Transparency Rule. The updated technical implementation guide—which contains data dictionaries, CSV...more

McDermott+

The Major Regs Are Out! Will Congress Intervene in of the “Final” Policies?

McDermott+ on

A few weeks ago, Regs & Eggs discussed the constant give and take between federal agencies and Congress as they both work on overlapping policies and objectives. The major regs released last week provide an excellent example...more

McDermott+

Previewing the Final Hospital Outpatient Medicare Payment Reg

McDermott+ on

Sharpen your pencils and locate your reading glasses: the final Medicare payment regulations for calendar year (CY) 2024 will be released within the next week. In the last Regs & Eggs blog post, I discussed a major issue...more

McDermott+

Breaking Down the CY 2024 Hospital Outpatient Proposed Reg

McDermott+ on

As most of you already know, the Centers for Medicare & Medicaid Services (CMS) recently released two Medicare payment regulations: the Calendar Year (CY) 2024 Physician Fee Schedule (PFS) proposed reg and the CY 2024...more

Nelson Mullins Riley & Scarborough LLP

Hospital Price Transparency Changes in the Calendar Year 2024 Hospital Outpatient Prospective Payment System Proposed Rule

As part of the Calendar Year 2024 Outpatient Prospective Payment System and Ambulatory Surgical Center Proposed Rule issued on July 13, 2023, the Centers for Medicare and Medicaid Services (CMS) proposed changes to the...more

King & Spalding

CMS Issues Outpatient Prospective Payment System Final Rule for CY 2022

King & Spalding on

On November 2, 2021, CMS published the final rule to update the payment policies and rates for services furnished under the Medicare Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgery Center (ASC) Payment...more

ArentFox Schiff

2022 HOPPS Final Rule Addresses Hospital Price Transparency

ArentFox Schiff on

New Rule Finalizes Penalties for Violating the 2021 Price Transparency Rule - On November 2, 2021, CMS published the 2022 Hospital Outpatient Prospective Payment System Final Rule that addressed its previously-proposed...more

Husch Blackwell LLP

CMS Releases OPPS and PFS Final Rules

Husch Blackwell LLP on

There were no major surprises when the Medicare hospital outpatient prospective payment system (OPPS) and physician fee schedule (PFS) Final Rules were released on November 2, 2021, but there are still several financial and...more

Sheppard Mullin Richter & Hampton LLP

CMS Backs Off Price Transparency for Providers and Plans

On August 2, 2021, the Centers for Medicare and Medicaid Services (“CMS”) issued its hospital inpatient prospective payment system (“IPPS”) final rule (“Final Rule”) for fiscal year 2022. In addition to a number of other...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 30, Number 28. News Briefs: August 2021

Report on Medicare Compliance 30, no. 28 (August 2, 2021) - CMS has not fined any hospitals yet for noncompliance with price transparency requirements, a spokesperson tells RMC. “In April 2021, CMS began issuing warning...more

K&L Gates LLP

CMS Proposes to Increase Penalties for Hospital Price Transparency Noncompliance

K&L Gates LLP on

On 19 July 2021, the Centers for Medicare & Medicaid Services (CMS) released the 2022 Outpatient Prospective Payment System/Ambulatory Surgery Center Payment System proposed rule (OPPS Proposed Rule),1 which includes a...more

Bricker Graydon LLP

The new price transparency rule: Are you ready?

Bricker Graydon LLP on

On November 27, 2019, the Centers for Medicare and Medicaid Services (CMS) published its final rule outlining new price transparency requirements as part of the 2020 update to the Outpatient Prospective Payment System....more

Health Care Compliance Association (HCCA)

CY 2020 Hospital Outpatient Prospective Payment System (OPPS) policy changes: Hospital price transparency requirements

Compliance Today (January 2020) - A Centers for Medicare & Medicaid Services (CMS) Fact Sheet issued November 15, 2019, “finalized policies that follow directives in President Trump’s Executive Order, entitled ‘Improving...more

King & Spalding

CMS Publishes Final Rule for CY 2020 Hospital Outpatient Prospective Payment System

King & Spalding on

n November 1, 2019, CMS posted the final rule establishing the payment rates for the Hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgery Center (ASC) Payment System for calendar year (CY) 2020...more

Polsinelli

CMS Delays Price Transparency, Doubles Down on Site-Neutral and 340B Payment Policies in CY 2020 OPPS Final Rule

Polsinelli on

Late last week, the Centers for Medicare & Medicaid Services (“CMS”) released the CY 2020 Hospital Outpatient Prospective Payment System (“OPPS”) final rule [CMS-1717-FC]. While many hospitals had hoped for relief from recent...more

Morgan Lewis

CMS Forges Ahead with Price Transparency, Major Payment Reductions in Proposed OPPS Rule

Morgan Lewis on

The Centers for Medicare and Medicaid Services’ proposed outpatient prospective payment system rule contains a number of significant changes and proposals impacting hospital operations and payments in calendar year 2020,...more

Wilson Sonsini Goodrich & Rosati

CMS Releases Key 2020 Payment and Policy Proposals

On July 29, 2019, the Centers for Medicare & Medicaid Services (CMS) issued three proposed rules on payment updates and policy changes for calendar year 2020 under 1) the Medicare Hospital Outpatient Prospective Payment...more

ArentFox Schiff

CMS Releases CY 2020 Proposed Hospital Outpatient Payment Rule

ArentFox Schiff on

On July 29, 2019, the Centers for Medicare & Medicaid Services issued the proposed CY 2020 Medicare Hospital Outpatient Prospective System and Ambulatory Surgical Center Payment System (Proposed Rule)....more

King & Spalding

CMS Publishes Proposed Rule for CY 2020 Hospital Outpatient Prospective Payment System, Includes Major Proposals on Price...

King & Spalding on

On July 29, 2019, CMS published a proposed rule revising the factors for determining Medicare payment rates under the Hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgery Center (ASC) Payment...more

McDermott Will & Emery

Proposed OPPS Changes for 2020: A Review of Four Key Proposals

The Centers for Medicare and Medicaid Services has released proposed updates to payment rates and regulations applicable to the Hospital Outpatient Prospective Payment System for Calendar Year 2020, including proposals...more

Sheppard Mullin Richter & Hampton LLP

Proposed and Expanded Disclosure Obligations for Hospitals Regarding not Only Gross Charges, but Third Party Payor Pricing as Well

On July 29, 2019, CMS released its proposed outpatient prospective payment system (“OPPS”) rule outlining a variety of changes it may implement for calendar year 2020. One proposal that has inspired immediate reactions from...more

Polsinelli

CMS Takes Bold Action on Price Transparency & Physician Supervision in CY 2020 OPPS Proposed Rule

Polsinelli on

On July 29, 2019, the Centers for Medicare & Medicaid Services (“CMS”) released the CY 2020 Hospital Outpatient Prospective Payment Systems (“OPPS”) proposed rule [CMS-1717-P]. ...more

Holland & Knight LLP

Executive Order on Healthcare Price Transparency

Holland & Knight LLP on

On June 24, 2019, President Trump signed a long-awaited executive order that he said would "fundamentally" change the healthcare market. The order builds upon current regulations that require hospitals to make available a...more

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