Summary: Details of Final Outpatient Payment Rule
What’s Happening: A comprehensive summary of the finalized payment updates and policy changes to the Medicare outpatient prospective payment system for calendar year 2024 is available.
What Else to Know: The provisions are generally effective Jan. 1, 2024.
Updated Guide on Final Rule Implementation Now Available
What’s happening: A members-only guide from the American Hospital Association to support hospitals in the implementation of the Medicare Advantage (MA) final rule is now available for calendar year 2024.
What else to know: The document provides a summary of key provisions of the final rule, which seeks to align MA coverage with traditional Medicare more clearly and to increase oversight of MA plans.
Hear From DataGen About the Outpatient Payment Final Rule
What’s Happening: A DataGen webinar on Dec. 5 at noon (PT) will provide an overview of the calendar year 2024 outpatient prospective payment system final rule. What Else to Know: Registration is required.
Summary: Providers Would Face Financial Penalties for Information Blocking
What’s happening: A members-only summary from Health Policy Alternatives, Inc., of the proposed rule on information blocking details provider disincentives related to programs from the Centers for Medicare & Medicaid Services.
What else to know: Comments on the proposed rule are due Jan. 2.
2023 Legislative Wrap-Up
Physicians Will See Medicare Payment Cuts Next Year
What’s happening: The Centers for Medicare & Medicaid Services’ (CMS) 2024 physician fee schedule final rule reduces Medicare payments to physicians by 1.23% compared to the prior year.
What else to know: The final 2024 physician fee schedule conversion factor is $32.74, a decrease of $1.15, or 3.4%, from 2023.
Access to Mental Health Services Could Increase for Medicare Advantage Enrollees
What’s happening: The Centers for Medicare & Medicaid Services (CMS) proposes policy changes for Medicare Advantage (MA) plans in contract year (CY) 2025.
What else to know: Comments on the proposed rule, which addresses MA policies such as prior authorization, outpatient behavioral health and supplemental benefits, are due Jan. 5.
CMS Finalizes Inadequate Outpatient Payment Update
What’s happening: The Centers for Medicare & Medicaid Services (CMS) has finalized the calendar year (CY) 2024 outpatient prospective payment system rule.
What else to know: It includes a net market basket update of 3.1%, which is a slight increase over the proposed 2.8%.
Certain 340B Hospitals to Receive Lump-Sum Settlement
What’s happening: A final rule from the Centers for Medicare & Medicaid Services (CMS) contains a remedy for the agency’s 340B-acquired drug payment policy that was in effect from 2018 to 2022.
What else to know: Eligible hospitals will receive a lump-sum settlement for claims, including beneficiary cost sharing, as a result of CMS’ invalidated policy that reduced payments for separately payable outpatient drugs acquired under the 340B program.
Payments to Renal Disease Facilities Increasing for 2024
What’s happening: The Centers for Medicare & Medicaid Services’ final rule details the end-stage renal disease prospective payment system for calendar year 2024.
What else to know: The base rate will increase to $271.02.