CMS Releases CY 2022 Outpatient Prospective Payment System Proposed Rule – AAMC

On July 19, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2022 Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule. Comments are due Sept. 17, 2021.

Notably, the proposed rule contains several modifications to the price transparency of hospital standard charges requirements. The CMS is proposing to increase the civil monetary penalties (CMPs) for noncompliance with the price transparency requirements and update the list of activities that present barriers to access to machine-readable files.

In addition, the CMS is soliciting comments on several issues including reporting of health disparities and extending temporary COVID-19 policies.

Among the proposals are the following key updates for academic medicine:

Payment Proposals

Payment Update: The CMS is proposing to increase payment rates for hospitals that meet applicable quality reporting requirements by 2.3%.

Ratesetting Data Set: The CMS is proposing to use CY 2019 data to set CY 2022 OPPS and ASC payment system rates. The CMS believes that due to a number of COVID-19 public health emergency-related factors, the CY 2020 data are not the best overall approximation of expected outpatient hospital services in CY 2022. 

Hospital Price Transparency: In response to President Biden’s executive order to support existing hospital price transparency rules, the proposed rule increases penalties for noncompliance with the hospital price transparency rules. For hospitals with 30 or fewer beds, a minimum CMP of $300 per day would be imposed for noncompliance. The penalty would rise by an additional $10 per
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