CMS is suggesting big changes in its proposed 2022 Hospital Outpatient Prospective Payment System and ASC Payment System rule released July 19
Tony Mira, founder of Anesthesia Business Consultants, laid out the key details for anesthesiologists in an Aug. 4 email.
Here's what you need to know:
1. Price transparency
The 2022 proposed rule calls for the following changes to the Hospital Price Transparency final rule that came into effect Jan. 1:
- Increase in civil monetary penalties to a minimum of $300 per day that would apply to smaller hospitals.
- Modification to the hospital price transparency regulation's deeming policy to include state forensic hospitals as meeting requirements.
- Update the list of activities that present barriers to access to the machine-readable file.
- Clarify that an online price estimator tool must provide a cost estimate to an individual that takes the individual's insurance information into account.
2. Payment rates
CMS is proposing to update payment rates for hospitals and ASCs that meet applicable quality reporting requirements by 2.3 percent.
3. Inpatient-only list
CMS proposes to rescind its elimination of the IPO list and adds the 298 services removed from the IPO list in 2021 back to the list in 2022.
CMS also is proposing to revise the exemption for procedures removed on or after Jan. 1 from the IPO list to the exemption period that was previously in effect — two years — so that all services eventually are subject to medical review.
4. Payment for non-opioid products
CMS is proposing to modify its policy to provide for separate or modified payment for non-opioid pain management drugs and biologicals that function as supplies in the ASC setting.
5. Payment for drug, device and biological pass-through
For 2022, CMS received eight applications for device pass-through payments. The Shockwave C2 Coronary Intravascular Lithotripsy catheter received preliminary approval for pass-through payment status.