Payment-rate hike proposed for outpatient, ambulatory centers

The CMS proposed a 2.1% payment-rate increase to hospital outpatient departments and a 1.3% boost to ambulatory surgery centers for 2013. Based on these rates, the CMS expects total payments for services to Medicare beneficiaries at hospital outpatient departments to total about $48.1 billion next year, while payments to ambulatory surgery centers should amount to about $4.10 billion. Payments to hospital outpatient departments are based on a formula that is equal to the hospital marketbasket (which represents an inflation rate of goods and services that hospitals use for inpatient services) of 3% minus a 0.9% adjustment for productivity. The agency also indicated that it will continue a 2% reduction in payments for those hospitals that don’t meet hospital outpatient quality reporting requirements. For the approximately 5,000 ambulatory surgery centers that participate in the Medicare program, the CMS is proposing additional requirements for the ASC quality reporting program that apply to the reporting of quality data, a policy for updating measures, and requirements related to data completeness. The nearly 700-page proposed rule also suggests changes to the inpatient rehabilitation quality reporting program and changes to the quality improvement organization program. For instance, QIOs would have the authority to send and receive secure transmissions of electronic versions of health information, and beneficiaries could authorize the QIOs’ use and disclosure of confidential information.