Q: How do we to handle charges for donor-related services when the donor is an unsuccessful match? Should the charges for services provided to a potential donor who is an unsuccessful match also be included on the transplant recipient claim or should they be adjusted and just included on the cost report?
CMS is weighing an expansion of the hospital outpatient department prior authorization program, changes to 340B reimbursement in the wake of the Supreme Court’s decision, and alternative rate setting data among other proposals in the 2023 Outpatient Prospective Payment System (OPPS) proposed rule.
NAHRI Advisory Board member Jugna Shah, MPH, CHRI,president of Nimitt Consulting, Inc., in Spicer, Minnesota, discusses how advocating for fair reimbursement and payment systems and raising awareness of the rules governing hospital pricing is fundamental to revenue integrity.