Here’s the latest PPS news
At press time, the final prospective payment system (PPS) regulation for ambulatory surgery centers was expected to be published in early 2001. Previously, the final rule was to be published this month. Same-day surgery insiders now say they expect the PPS to be implemented in January 2002.
As this issue of Same-Day Surgery was readied for publication, the Senate was debating a bill that would offer relief from the Balanced Budget Act and extend the three-year phase-in of the surgery center PPS to four years. (For the current status of S. 1788, Medicare, Medicaid, and SCHIP Adjustment Act of 1999, go to this Web site: thomas.loc.gov.)
In news for hospitals, the outpatient PPS (OPPS) for hospitals, which was implemented in August, is expected to result in a 6% to 8% drop in Medicare funding for the average hospital, according to a report from Fitch, an international rating agency in New York City and London.
Because other payers are likely to adopt the PPS system, the actual drop could be even higher, the agency warns. Also, hospitals could see a 40% increase in the collection period for Medicare outpatient claims, which could add one to two days in accounts receivable, the report says. The report also addresses the challenges of converting to the outpatient PPS system. "Inaccurate claim submissions will cause a more significant financial impact than the actual decrease in payments due to reduced reimbursement rates, and the most important factor in determining the financial impact is the degree to which hospitals have prepared for the complexities of implementing the new APC system," says Anil M. Joseph, an analyst for Fitch.
For a copy of Credit Implications of Medicare Ambulatory Payment Classifications (APCs) visit Fitch’s Web site: www.fitchratings.com.
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