The Centers for Medicare & Medicaid Services (CMS) on Tuesday released the 2022 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Final Rule.
In addition to updating payment rates and taking steps to increase pricing transparency, the rule boosts Medicare beneficiary quality and safety by halting the phased elimination of the Inpatient Only list (IPO) for surgical procedures.
Here are three things to know about the rule:
Reinstates the IPO list: Last year CMS finalized a policy to eliminate the IPO list over a three-year period, removing nearly 300 services in the first phase. Due to pushback from those concerned with the safety of performing certain procedures in an outpatient setting, the latest rule halts the elimination of IPO and adds all back to the list except for lumbar spine fusion, reconstruction of shoulder joint, reconstruction of ankle joint, and their corresponding anesthesia codes.
Considers future actions to advance health equity: In the proposed rule, CMS asked for comments on potential proposals and actions to advance health equity. The feedback will help inform future rulemaking around these topics. CMS said stakeholders submitted input on ways to make reporting of health disparities based on social risk factors and race and ethnicity more comprehensive and actionable by including additional demographic data points, such as race, ethnicity, Medicare/Medicaid dual eligible status, disability status, LGBTQ+, and socioeconomic status.
Considers lessons from COVID-19: CMS also asked for comments on the extent to which hospitals are using flexibilities offered during the COVID-19 public health emergency (PHE) to provide mental health services remotely and whether CMS should consider changes to account for shifting practice patterns. In addition, the agency also received input on the collection and reporting of COVID-19 vaccination status of hospital outpatient department and ASC staff and making this information available to the public, so consumers know how many workers are vaccinated in different health care settings.
For more information, click to access the CMS announcement, CMS fact sheet, and the final rule, which is on display at the Federal Register and scheduled to be published on Nov. 16.