The American Hospital Association (AHA) and the Association of American Medical Colleges (AAMC) recently filed a lawsuit against the Department of Health and Human Services (HHS) for continuing to reduce payments for hospital outpatient services provided in grandfathered, off-campus provider-based departments (PBD) in the fiscal year 2020 Outpatient Prospective Payment System final rule.
The Transparency in Coverage Proposed Rule comment period has been extended from January 14 to January 29, CMS announced. The proposed rule would require insurers to provide personalized price estimates and publish negotiated in-network rates and historical payment information.
CMS is automatically reprocessing 2019 hospital claims for certain services provided at grandfathered off-campus provider-based departments (PBD) after a federal judge vacated portions of the 2019 outpatient prospective payment system (OPPS) final rule. However, the agency has filed an appeal and the same federal judge declined to strike down cuts for those services planned for 2020.
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.
CMS is accepting comments until November 29 on a proposal to collect acquisition cost data from hospitals participating in the 340B drug discount program.
A federal judge rejected CMS’ motion to reconsider or issue a stay on her September order to vacate cuts to reimbursement to grandfathered off-campus provider-based departments.
CMS’ proposal mandating the disclosure of negotiated charges between hospitals and payers may exceed the agency’s legal authority and would have limited benefit to patients, according to the AHA.
