Review major components of the 2018 OPPS proposed rule

Why This Topic Matters

The proposed rule includes multiple policy changes that could affect hospital outpatient payment, claim reporting, and administrative workflows. Understanding the broad scope helps providers assess operational impact and prepare comments or internal updates.

Article Sections

1. Payment changes for 340B

   Overview of proposed outpatient payment adjustments tied to the 340B drug discount program and related data collection considerations.

2. Packaging for drug administration

   Discussion of proposed packaging changes for certain drug administration services and how CMS is approaching broader bundling in OPPS.

3. Few proposals regarding C-APCs/APCs

   Summary of proposed APC and C-APC-related updates, including imaging and brachytherapy-related payment structure changes.

4. Modifier changes proposed

   Review of proposed modifier updates connected to outpatient payment policies and imaging-related reporting changes.

5. Inpatient-only list proposals

   Discussion of proposed revisions to the inpatient-only list and related APC assignments for selected procedures.

6. Provider-based department updates

   Overview of payment policy issues affecting off-campus provider-based departments and related reimbursement adjustments.

7. Direct supervision moratorium returns

   Summary of proposed temporary nonenforcement of direct supervision requirements for certain hospital outpatient services in qualifying facilities.

8. Additional changes

   Other proposed OPPS updates, including changes affecting chronic care management codes and donor acquisition payment status.

9. Providing feedback

   Closing section on CMS comment opportunities, stakeholder feedback, and the proposed rule comment deadline.