2019 OPPS proposed rule: CMS pushes for site-neutral reimbursement, lower drug payments

Why This Topic Matters

The proposal could materially affect hospital outpatient reimbursement, departmental payment patterns, and operational planning for facilities that furnish outpatient clinic and other services under OPPS. It also signals how CMS may approach future outpatient utilization controls and payment adjustments tied to outpatient department services and 340B drugs.

Article Sections

1. Physician payments

   Discusses proposed outpatient payment changes affecting off-campus provider-based departments and the comparison between outpatient and physician-fee-schedule payment approaches. It also summarizes CMS’s request for comment on broader outpatient utilization and payment policy topics.

2. 340B payment reductions expanded

   Covers CMS’s proposal to extend reduced payment treatment for drugs acquired under the 340B drug discount program to additional facility types. It notes which provider categories remain excepted under the proposal.