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CMS Releases Physician Fee Schedule and Hospital Outpatient/Ambulatory Surgical Center Proposed Rules for Calendar Year 2014

Stuart M. Langbein

Stuart M. Langbein,

Washington, D.C.

Beth L. Roberts

Beth L. Roberts,

Washington, D.C.

Beth Halpern

Emily Gebbia

Emily Stopa

Andrew Furlow

08 July 2013
The Centers for Medicare and Medicaid Services has put on display at the Federal Register two proposed rules addressing Medicare 2014 payment rates.

The first rule is the Medicare physician fee schedule proposed rule.  This proposed rule would update payment policies and payment rates for services paid under the Medicare physician fee schedule on or after January 1, 2014.  In addition, the rule proposes changes to several quality reporting initiatives that relate to physician fee schedule payments, and continues the implementation of the physician value-based payment modifier that affects payments to physician groups based on the quality and cost of care they furnish to Medicare beneficiaries.

The second rule issued today is the proposed rule addressing the payment system and policy changes for the hospital outpatient prospective payment system (OPPS) and the ambulatory surgical center (ASC) payment system.  This rule would update Medicare payment policies and rates for hospital outpatient and ASC services furnished on or after January 1, 2014.  The OPPS portions of the proposed rule include a proposed payment update, proposals for additional packaging of services, and a proposal to continue to pay for non-pass-through drugs at average sales price plus 6%.  The ASC portions of the proposed rule address the ASC payment update, additional packaging of services, and the failure of ASCs to meet quality reporting requirements.

The above topics are just glimpses of what is contained in these two proposed rules that total more than 1300 pages.  Both rules are subject to a 60 day comment period and CMS will accept comments on both until September 6, 2013.  The proposed rules will be published in the Federal Register on July 18, 2013.  In the interim, the rules should be available in the links provided above.  While there have been difficulties accessing the rules through these links, that is likely due to high traffic which should resolve shortly.

Stuart M. Langbein

Stuart M. Langbein,

Washington, D.C.

Beth L. Roberts

Beth L. Roberts,

Washington, D.C.

Beth Halpern

Emily Gebbia

Emily Stopa

Andrew Furlow

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