CMS is proposing to hike penalties on hospitals that don’t abide by price transparency requirements from $300 daily to potentially thousands of dollars for larger facilities, part of an outpatient payment rule that’s a mixed bag of potential wins and losses for providers.
In the proposed 2022 Outpatient Prospective Payment System rule released Monday, the agency also wants to halt the Trump administration’s elimination of the inpatient-only list and is seeking comment on how best to update outpatient and ambulatory surgical center quality reporting programs to include more information related to health equity.
Providers heavily opposed the plan to eliminate the IPO list when it was announced in December, as it would have meant losing some business to outpatient facilities.
The Ambulatory Surgery Center Association, with members that could benefit from procedures moving off the inpatient only list, said the back and forth over the issue has been “jarring,” calling for a clear process for providers to submit data on procedures “they believe can be safely performed” in ASCs.
Medical device makers could benefit from increased volume in allowing more procedures to be performed outside a hospital’s four walls, though they tend to get lower reimbursement at such facilities.
Hospitals notched a hit with the proposals over price transparency. The hospital lobby lost a legal battle to forestall the requirements altogether. Also, CMS is retaining the cut in 340B drug payments that hospitals are fighting in the courts. The U.S. Supreme Court agreed earlier this month to hear the case.