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Medicare and Medicaid Programs - Hospital Outpatient Prospective Payment - Ambulatory Surgical Center Payment - Hospital Value-Based Purchasing Program (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Medicare and Medicaid Programs - Hospital Outpatient Prospective Payment - Ambulatory Surgical Center Payment - Hospital Value-Based Purchasing Program (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) for CY 2012 to implement applicable statutory requirements and changes arising from our continuing experience with this system. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the OPPS. This book contains: - The complete text of the Medicare and Medicaid Programs - Hospital Outpatient Prospective Payment - Ambulatory Surgical Center Payment - Hospital Value-Based Purchasing Program (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section
Medicare pays for surgical procedures performed at ambulatory surgical centers (ASC) and hospital outpatient departments through different payment systems. Although they perform a similar set of procedures, no comparison of ASC and hospital outpatient per-procedure costs has been conducted. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 directed GAO to compare the relative costs of procedures furnished in ASCs to the relative costs of those procedures furnished in hospital outpatient departments, in particular, how accurately the payment groups used in the hospital outpatient prospective payment system (OPPS) reflect the relative costs of procedures performed in ASCs. To do this, GAO collected data from ASCs through a survey. GAO also obtained hospital outpatient data from the Centers for Medicare & Medicaid Services (CMS).
GAO-07-86 Medicare: Payment for Ambulatory Surgical Centers Should Be Based on the Hospital Outpatient Payment System