AHA Expresses Concern About Medicare Outpatient Payment Changes

The American Hospital Association has expressed concerns about various aspects of CMS' outpatient prospective payment system proposals for calendar year 2014.

First, the AHA sent a letter to the Medicare agency saying it is disappointed that CMS plans to allow contractors to enforce direct supervision requirements for outpatient therapeutic services performed in critical access hospitals and other small, rural facilities. This policy is unnecessary and could lead to reduced access to care for Medicare beneficiaries, according to the AHA.

Second, the organization has voiced concerns about proposals concerning changes in outpatient payment packaging, comprehensive ambulatory payment classifications and hospital outpatient visit coding and payment. Although the AHA generally supports reforms working toward larger units of payment, the association has reservations about the accuracy of the data CMS used to back up its proposed changes.

Due to those reservations, the complexity of the data and the short timeframe until implementation, the AHA has asked the agency to take more time to analyze and validate the proposed changes and study their potential impact on individual hospitals.

Furthermore, the AHA opposes a proposal to collapse hospital outpatient visit codes into a single code for each type of visit, saying the policy change would incorporate too wide of a range of case severities into a single pay rate. However, the association does support eliminating the distinction between new and established patient visits.

Earlier this month, CMS issued corrections to address various technical errors contained in its original outpatient payment system proposed rule.

More Articles on Medicare Payments:
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