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CMS Releases its CY 2012 OPPS Final Rule

CMS Releases its CY 2012 OPPS Final Rule
Sunday, November 6, 2011

CMS has released its CY 2012 Outpatient Prospective Payment System (OPPS) Final Rule, effective January 1, 2012.  Notable provisions of the Final Rule include:

  • A market basket update of 1.9%.
  • Adjustment to payment rates for certain cancer hospitals.
  • A process for the APC Panel to evaluate requests for alternative supervision levels for hospital outpatient therapeutic services and issue recommendations to CMS on the same.
  • The addition of three quality measures for hospital outpatient departments to report for purposes of the CY 2014 and CY 2015 payment determinations.  The new measures include: (i) a measure relating to cardiac rehabilitation patient referrals; (ii) a measure relating to the use of a safe surgery checklist; and (iii) a measure relating to hospital outpatient department volume for selected surgical procedures.
  • A reduction in the number of randomly selected hospitals (from 800 to 450) for validating hospital outpatient quality reporting data for the CY 2013 payment determination.
  • Revisions to the hospital value-based purchasing program.
  • A process for physician-owned hospitals to apply for an exception to the federal prohibition on expanding facility capacity in physician-owned hospitals.

You may review a display copy of the Final Rule here or CMS’ summary here.

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