skip navigation

CMS’s HOPD/ASC Proposed Rule Asks for Comments on Outpatient TKA

July 12, 2016

Last week, the Centers for Medicare and Medicaid Services (CMS) released the CY 2017 Hospital Outpatient Prospective Payment System (HOPPS) and Ambulatory Surgery Center (ASC) proposed rule.

TOA members can view TOA’s four-page analysis in their e-mail newsletter or by clicking here and accessing it via this article in the Member’s Only section.

Some of the highlights include:

TKA & Inpatient Only List.    CMS asked for comments regarding the potential removal of TKA from the inpatient only list in a future year.   If you feel strongly one way or the other about this issue, you should provide comments to CMS.

Four Spine Procedures Added to Outpatient.    CMS is proposing to remove four additional spine procedures from the inpatient only list.

Pain Management Removed from HCAHPS.    CMS is proposing to remove the pain management score from the hospital HCAHPS score.

90-day EHR MU Period.   CMS is proposing to base the EHR meaningful use score on a 90-day period instead of the entire year.

Tighten the Site Neutral Payment Provision for PBDs. CMS is proposing to tighten up the site neutral payment initiative passed by Congress in November 2015 that targets off-campus, provider-based departments (PBDs) of hospitals. The hospital lobby will fight this CMS proposal to prevent higher OPPS payments to PBDs if they move to a new building or tear down the grandfathered building.

The following was the lead paragraph from Modern Healthcare’s July 9th article on the subject: “Hospitals are livid about the Obama administration’s plans to eliminate their Medicare payments for services at new off-campus  outpatient  departments, saying it ignores the intent of Congress and will limit access to care.”