Patient Options Expand with OPPS Proposed Rule, as 340B Hospitals see Increased Cuts

By Susan Gatehouse, RHIT, CCS,CPC, AHIMA-Approved ICD-10-CM/PCS Trainer

​Released Aug. 4, the Outpatient Prospective Payment System (OPPS) proposed rule for 2021 would eliminate the Medicare inpatient-only list of services while increasing the number of Ambulatory Service Center (ASC)-eligible procedures. The rule would also increase 340B payment cuts, and looks to overhaul the hospital star-rating system.

As outlined in the OPPS proposed rule for 2021, CMS seeks to eliminate the list of services that can be performed on an inpatient-only basis for Medicare patients over the next three years, starting with the removal of approximately 300 musculoskeletal-related services.  Other significant changes within the OPPS proposed rule will impact payment methodologies for 340B-purchased drugs.  

In an article published by ICD-10 Monitor News, Axea Solutions CEO, Susan Gatehouse examines some of the impacts of these changes, outlining areas of concern and awareness particularly for 340B participating facilities, as the proposed rule reserves an almost 30-percent cut to payment of certain drugs for 340B hospitals.

You can read the entire article  ​HERE. 

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