Hospitals receive 3.8% rate increase
However, less overall payment may be end result
The Centers for Medicare & Medicaid Services (CMS) has proposed a 3.8% increase for the hospital outpatient prospective payment system (OPPS) for 2004.
While that seems like good news for hospitals on the surface, there is bad news:
Certain outpatient payment provisions, including the transitional corridor payments and the hold harmless payments, are expiring at the end of this year. These provisions were put in place to help hospitals transition to OPPS, says Ashley Thompson, senior associate director of policy development at the American Hospital Association (AHA) in Washington, DC.
The loss of these additional payments will be greater than hospitals are expected to receive in the update, Thompson says. "Hospitals will receive less money in 2004 than in 2003," she says.
At press time, the AHA was working with Congress to have the transitional payment categories extended, Thompson says. "The OPPS is a mess," she says. "It’s still in its infancy, and rates are still all over the board. Hospitals need those other payments to protect them in the transition."
On the positive side for hospitals, the proposed rule extends the "dampening rule" that was established in 2003. This extension means that some hospital ambulatory payment classifications that would decrease by more than 15% in 2004 would be shielded from dramatic losses. Also, a separate outlier threshold would be created for hospitals.
At press time, the proposed rule was scheduled to be published in the Aug. 12 Federal Register. To access the Federal Register, go to www.gpoaccess.gov/fr/index.html. The final rule will be published around Nov. 1. The new rule takes effect Jan. 1, 2004.
The Centers for Medicare & Medicaid Services (CMS) has proposed a 3.8% increase for the hospital outpatient prospective payment system (OPPS) for 2004.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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