CMS Proposes Rules for New Rates

CMS just released a proposed rule to update its approach for paying hospital outpatient and ambulatory surgery center services.

The new rates are based on a 50-50 blend of the 2007 payment rate and the 2009 payment, which represents 65 percent of the hospital outpatient rate.

According to CMS, the proposed rule will build on efforts across Medicare to transform the program into a prudent purchaser of healthcare services, paying based on quality of care, not just quantity of services.

The new rule would include a 3 percent annual inflation update to Medicare payment rates for most services that would be paid under the outpatient PPS. That increase would apply to hospitals that report data on seven outpatient quality measures. Facilities not submitting the data would receive only a 1 percent update.

More than 4,000 hospitals and community mental health centers are expected to participate in the program in 2009.