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CMS recently relaunched the Program for Evaluating Payment Patterns Electronic Report (PEPPER) for short-term acute care hospitals, restoring these facilities’ access to a valuable data tool that assists with claim accuracy.
CMS is preparing to launch the Outpatient Prospective Payment System (OPPS) Drug Acquisition Cost Survey to collect acquisition costs for certain outpatient drugs and biologicals.
CMS recently created a new system edit to help reduce improper Medicare payments for outpatient services provided by acute care hospitals to hospice patients.
CMS moved ahead with significant expansions to its site neutral payment policies, including reductions to payments for certain services at expected off-campus provider based departments (PBD), additional price transparency requirements, changes to its methodology for setting MS-DRG rates, and more, according to the 2026 Outpatient Prospective Payment System (OPPS) final rule.
After receiving negative feedback from industry stakeholders on its new reimbursement approach for certain inpatient Medicare Advantage (MA) claims, Aetna recently extended the policy’s implementation date.
