tci Medicare Compliance & Reimbursement - 2005 Issue 31

HOSPITALS: Payment Increases Highlight Proposed OPPS Rule

Medicare patients could enjoy lower coinsurance rates for outpatient services.The Centers for Medicare and Medicaid Services wants to pay hospitals more for most Part B drugs, biologicals and radiopharmaceuticals administered in their outpatient departments.Acute care hospitals could receive a 3.2 percent inflation adjustment to their payment rates under the Outpatient Prospective Payment System in 2006, CMS announced July 18. CMS' proposed rule contains policy changes and updated payment rates, including:   Coinsurance rates will decrease gradually to 20 percent of the hospital's total payment for 12 additional medical and surgical ambulatory payment classifications.   Sole...

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