Healthcare News: CMS adjusts inpatient-only list in 2018 OPPS final rule

Why This Topic Matters

The article highlights policy changes that can affect where certain procedures are performed, how they are classified for hospital payment, and how providers monitor Medicare payment and compliance impacts. It is useful for readers following CMS final rule updates and inpatient versus outpatient setting changes.

Article Sections

1. Overview of the 2018 OPPS final rule

   Introduces the rulemaking context and the broad areas of stakeholder interest discussed in the article.

2. Procedure removed from the inpatient-only list

   Describes one procedure CMS moved out of the inpatient-only list and notes related payment classification information.

3. Stakeholder concerns and CMS response

   Summarizes provider concerns about broader Medicare program effects and CMS’s stated approach to monitoring volume and case mix.

4. Recovery Auditor review limitation

   Covers a temporary restriction on certain reviews tied to inpatient total knee arthroplasty cases.

5. Additional procedures removed from the inpatient-only list

   Lists other procedures CMS moved out of the inpatient-only list for the year and notes that they share the same general payment classification status.

6. Procedure added to the inpatient-only list

   Identifies the procedure CMS added to the inpatient-only list and the related outpatient payment classification status.

7. Rule availability

   Notes that the final rule and a CMS fact sheet are available for reference.