Outpatient Reimbursement: Proposed OPPS Rule Removes TKA from IPO List

Why This Topic Matters

The proposed rule may shift where certain procedures can be performed and how outpatient services are reimbursed, which can affect facility operations, payer mix, and reimbursement planning. Understanding the policy areas discussed helps stakeholders monitor Medicare updates and prepare for comment periods and final rule changes.

Article Sections

1. Overview of the proposed 2018 OPPS rule

   Introduces the timing and general direction of the proposed outpatient payment rule. Summarizes how the proposal affects different outpatient care settings.

2. Procedure policy changes under the inpatient-only list

   Discusses proposed movement of selected orthopedic procedures away from the inpatient-only list and the potential impact on facility settings. Also notes broader outpatient payment implications for related hospital and ambulatory surgery providers.

3. Cardiac services and ASC-payment policy

   Reviews proposed consideration of certain cardiac diagnostic and device-related services for ambulatory surgery center payment policy. Addresses the background of existing policy limitations and the request for public comment.

4. 340B drug payment changes

   Summarizes proposed changes to hospital payment methodology for drugs acquired under the 340B program. Notes the general direction of the payment adjustment and the response it may draw from provider groups.

5. Related Medicare physician payment proposal

   Briefly compares the outpatient proposal with a separate Medicare physician payment update affecting hospital-owned off-campus practices. Highlights the relevance of the comparison for payment alignment discussions.

6. Comment deadline and source resources

   Provides the public comment timeframe and points readers to official CMS and Federal Register resources. Includes links for reviewing the proposal and submitting feedback.