The Medicare law now requires that the annual OPPS payment inflation update be reduced by 2.0 percentage points for certain hospitals that do not meet quality reporting requirements. The final rule adopts four new quality measures for imaging efficiency, increasing the number of quality measures that HOPDs must report in 2009 to receive the full update in 2010 from the current seven measures to 11 measures. CMS says it will “continue to consider for future years 18 additional quality measures in areas ranging from screening for fall risk to cancer care that were identified in the CY 2009 proposed rule, as well as other quality and efficiency measures as appropriate.”
The final rule further emphasizes that an urgent and compelling rationale exists for CMS to exercise its existing administrative authority under the Medicare statute to develop and implement a policy that would not pay hospitals for care related to illness or injuries acquired by the patient during a hospital outpatient encounter: “Such a policy, which we expect to propose in the future, would be known as hospital outpatient healthcare-associated conditions (HOP-HACs), and it would make adjustments to OPPS payments to ensure equitable and appropriate payment for care, similar to the quality adjustments applied to payment for hospital-acquired conditions in the inpatient setting,” says CMS.
The final rule with comment will appear in the Nov. 18 Federal Register. Comments on designated provisions are due by 5:00 p.m. Eastern on Dec. 29, and a final rule responding to the comments will be published at a later date. Get more information on the CY 2009 final rule with comment period for the OPPS.
