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.  

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.   

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.