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CHA Issues CY 2020 Outpatient Prospect Payment System Proposed Rule Summary — Register for Member Forum

For CEOs, CFOs, and Government Relations, Quality & Patient Safety, and Finance & Reimbursement Staff

CHA has issued a summary of the Centers for Medicare & Medicaid Services’ (CMS) calendar year (CY) 2020 outpatient prospective payment system (OPPS) proposed rule. In addition, CHA will host a member forum on Sept. 11 at 1 p.m. (PT) to review several key provisions outlined below and to solicit member input for draft comments. Register for the forum by noon (PT) on Sept. 10. 

The proposed rule includes policies that would:

  • Adopt federal fiscal year (FFY) 2020 inpatient prospective payment system (IPPS) final rule area wage indices for CY 2020 OPPS
  • Continue the phase-in of payment changes for clinic services furnished in excepted off-campus provider-based departments
  • Establish a process for prior authorization for certain covered outpatient department services
  • Establish requirements for all hospitals to publicize standard charges and negotiated rates
  • Change the requirements for a medical device to qualify for device pass-through status
  • Revise coverage conditions for organ procurement organizations
  • Make changes to the inpatient-only list
  • Change the two-midnight policy for inpatient stays for procedures removed from the inpatient-only list
  • Change the minimum level of supervision required for hospital outpatient therapeutic services from direct supervision to general supervision

In addition, CHA DataSuite has issued hospital-specific analyses that show providers how Medicare outpatient FFS payments may change from CY 2019 to CY 2020 based on the policies set forth in the CY 2020 OPPS proposed rule, using the FFY 2020 IPPS final rule wage index.