Discharge Planning Advisor

Medicare hikes pay for outpatient services

Hospitals will get a 2.3% payment hike, effective Jan. 1, 2002, under the proposed rule for the outpatient prospective payment system (OPPS) released in late August by the Centers for Medicare and Medicaid Services (CMS). The rule would achieve the goal of making appropriate reimbursement payments given the ongoing shift of services from inpatient to outpatient setting, according to Tom Scully, CMS administrator.

While the rule outlines possible approaches for CMS in estimating payments for hospitals’ use of "pass-through" devices, drugs, and biological products in outpatient services, it makes no actual estimate. Congress required Medicare to make such payments temporarily, and capped them at 2.5% of the estimated overall amount paid under OPPS.

Currently, should the estimate exceed the cap, an across-the-board cut on all pass-through payments would be required. The proposed rule can be viewed at www.hcfa.gov/regs/propcy2002.htm.