As 2019 draws to a close, and as revenue integrity professionals and their organizations look to the future, an important set of decisions and changes await. Among the largest is that to come in 2021 when the new price transparency requirements for hospitals will be in place. CMS finalized the changes in the CY 2020 Hospital Outpatient Prospective Payment System (OPPS) Policy Changes: Price Transparency Requirements for Hospitals to Make Standard Charges Public final rule.
Expanded price transparency requirements are set to become reality for hospitals effective January 1, 2021. On November 15, CMS released a final rule that pushed ahead with many of the requirements originally included in the 2020 OPPS proposed rule.
CMS is moving forward with multiple policies—effectively based on reducing reimbursement to hospitals—that have been deemed unlawful in court, according to the 2020 OPPS final rule, released Friday, November 1.
Q: Our new EHR system was built using logic for therapy charging based on both the AMA and CMS eight-minute rules. Charges will generate differently based on the payer. How do others implement the eight-minute rules? How do you think using two charging methodologies in this world of price transparency will look?
