- Regulation No.
- Hospital Outpatient Prospective Payment- Notice of Proposed Rulemaking (NPRM)
Medicare Program: Proposed Changes to Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Requests for Information on Promoting Interoperability and Electronic Health Care Information, Price Transparency, and Leveraging Authority for the Competitive Acquisition Program for Part B Drugs and Biologicals for a Potential CMS Innovation Center Model
This proposed rule would revise the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2019 to implement changes arising from our continuing experience with these systems. In this proposed rule, we describe the proposed changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this proposed rule would update and refine the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program.
In this proposed rule, we also are including three Requests for Information on (1) promoting interoperability and electronic health care information exchange; (2) improving beneficiary access to provider and supplier charge information; and (3) leveraging the authority for the Competitive Acquisition Program (CAP) for Part B drugs and biologicals for a potential CMS Innnovation Center model. In addition, we are proposing to modify the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey measure under the Hospital Inpatient Quality Reporting (IQR) Program by removing the Communication about Pain questions.
- CMS-1695-P (PDF) - Opens in a new window
- CMS-1695-P (Text) - Opens in a new window
- 2019 NPRM OPPS Cost Statistics Files - Opens in a new window
- 2019 NPRM OPPS “Data Addendum B” and “2 Times Rule” File - Opens in a new window
- 2019 NPRM OPPS Addenda Table of Contents - Opens in a new window
- 2019 NPRM OPPS Addenda - Opens in a new window
- 2019 NPRM OPPS Facility-Specific Impacts - Opens in a new window
- 2019 NPRM OPPS Blood Revenue Code Cost to Charge Ratios - Opens in a new window
- 2019 NPRM OPPS Revenue Code-to-Cost Center Crosswalk - Opens in a new window
- FY 2019 Wage Index Home Page
- Proposed Changes to the Ambulatory Surgical Center Payment System and CY 2019 Payment Rates