Yesterday, the American Hospital Association (AHA), the Association of American Medical Colleges (AAMC) and America’s Essential Hospitals filed a lawsuit against the U.S. Department of Health and Human Services (HHS) in the U.S. District Court for the District of Columbia to prevent significant Medicare payment cuts for hospitals that participate in the 340B Drug Pricing Program. The three hospital associations are joined in the suit by hospital plaintiffs: Eastern Maine Healthcare Systems, in Brewer, Maine; Henry Ford Health System, in Detroit; and Park Ridge Health, in Hendersonville, North Carolina, part of Adventist Health System.

For 25 years, the 340B program has enabled hospitals and other organizations that care for many low-income and uninsured patients to purchase certain outpatient drugs from pharmaceutical manufacturers at discounted prices. The program allows participating hospitals to use the savings from the discounts to provide an expanded range of comprehensive health...

On September 8, KHA submitted comments to the Centers for Medicare and Medicaid Services (CMS) regarding the Medicare hospital outpatient prospective payment system (OPPS) proposed rule for calendar year (CY) 2018. The Association has significant concerns with this proposal's reductions in payment for 340B hospitals as well as changes to remove total knee replacement from the inpatient only list, which is unsafe and will negatively impact hospitals participating in the CMS Comprehensive Care for Joint Replacement (CJR) and the Bundled Payment for Care Improvements (BPCI) programs.

A copy of KHA's comments are available on the Policy page (members only) of www.kyha.com.

If you have any questions, please contact Nancy Galvagni at KHA (ngalvagni@kyha.com).

On September 6, KHA submitted comments to the Centers for Medicare and Medicaid Services on the calendar year (CY) 2017 hospital outpatient prospective payment system (OPPS) proposed rule that would implement site-neutral provisions of the Bipartisan Budget Act of 2015 (BiBA).

Kentucky's hospitals are opposed to CMS' site-neutral proposal because the rule would not only apply to new off-campus outpatient facilities but also to existing hospital outpatient departments (HOPDs) that expand services or relocate to benefit their communities by lowering payment.

For a full copy of KHA's comments, members may visit the Policy page of the Advocacy section of www.kyha.com.

If you have any questions, please contact Nancy Galvagni at KHA (ngalvagni@kyha.com).

CMS issued an invitation the public to comment on the Calendar Year (CY) 2017 Changes to the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) proposed rule . Comments are due by 5:00 p.m. (ET) next Tuesday, September 6.

The CY 2017 OPPS ASC proposed rule includes the following changes to the Medicare and Medicaid EHR Incentive Programs:

Eliminates the Clinical Decision Support (CDS) and Computerized Provider Order Entry (CPOE) objectives and measures beginning in 2017 and reduces the...

The proposed calendar year (CY) 2016 payment rule for the Medicare Outpatient Prospective Payment System (OPPS) was published in the July 8 Federal Register. The proposed rule includes annual updates to the Medicare fee-for-service (FFS) outpatient payment rates as well as proposed regulations that implement new policies.

The Healthcare Association of New York State (HANYS) has shared a high-level summary of the proposed rule.

A copy of the Federal Register (FR) and other resources related to the OPPS are available on the Centers for Medicare and Medicaid Services (CMS) website. Comments on all aspects of the proposed rule are due to CMS by August 31 and can be submitted electronically at http://www.regulations.gov...

On August 27, AHA submitted the comment letter to the Centers for Medicare and Medicaid Services (CMS) on its proposed rule for the calendar year (CY) 2015 outpatient and ambulatory surgery center (ASC) prospective payment systems (PPS). The letter urges the agency to carefully reconsider its proposed methodology of creating a Healthcare Common Procedure Coding System modifier to track services furnished in off-campus, provider-based hospital outpatient departments. It also recommends changes to the implementation of its new set of claims-level comprehensive ambulatory payment classifications to ensure that it does not negatively and disproportionately impact certain types of hospitals that have specialized case mixes. In addition, AHA opposes CMS’ proposal to require a physician order for all inpatient admissions as a condition of payment under the agency’s general...

The Centers for Medicare and Medicaid Services (CMS) has issued a proposed rule to update the Hospital outpatient prospective payment system (OPPS) and the ambulatory surgical center (ASC) payment system for calendar year (CY) 2015. CMS states that the proposed rule, which contains a 60-day comment period ending September 2, would update the payment policies and payment rates for services furnished to Medicare beneficiaries in hospital outpatient departments and ASCs beginning January 1, 2015.

KHA's Washington liaison Larry Goldberg has prepared an analysis and commentary on the proposal, which is available at http://www.new-kyha.com/Portals/5/NewsDocs/03Jul2014OPPSProposed.pdf.