Hospitals get breather on 2001 OPPS rates
Technical miscalculations’ cited
In what is welcome news for access managers, the Centers for Medicare & Medicaid Services (CMS) announced in late December 2001 that the 2002 Medicare hospital outpatient prospective payment system (OPPS) rates will be postponed until the agency conducts a review of the rates and codes announced Nov. 30, 2001 in the final regulation.
Hospitals will be paid at the 2001 OPPS rates until CMS finishes its review, which the agency said would not extend beyond March 31, 2002. CMS said it will process claims subject to OPPS for dates of service of Jan. 1 or later using the 2001 payment rates, while it continues to review the 2002 rates and codes announced in November.
Claims will be processed in a timely manner rather than being held for three months, the agency said.
The move comes after several health care entities, along with health care leaders in Congress, sent letters to Health and Human Services Secretary Tommy Thompson and CMS Administrator Thomas Scully requesting the delay to avoid unnecessary confusion to providers and beneficiaries.
Technical miscalculation
Since issuing the final regulation, CMS discovered a number of technical miscalculations in the assignment of the cost of certain new technology devices to related procedure codes, according to a news release by the CMS public affairs office.
Once the corrections are made, CMS will do a thorough review of all outpatient codes with medical experts and again review the data to make sure there are no additional calculation errors, the release stated. The revised rates and codes then will be published in the Federal Register.
There are more than 300 ambulatory payment classification codes (APCs) for outpatient services and 53 APCs that involve new technology devices.
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