On Nov. 2, the Centers for Medicare and Medicaid Services (CMS)
finalized its 2022 Outpatient Prospective Payment (OPPS) Rule.
Despite fierce pushback from WHA, the AHA and other hospital groups, CMS finalized a number of proposed policies harmful to hospitals. In its
comment letter, WHA had expressed opposition to continued cuts to 340B providers and hospital outpatient departments, while expressing equal concerns with the proposal to increase fines on hospitals CMS finds out of compliance with the Hospital Price Transparency Rule. Instead, WHA urged CMS to take a more collaborative approach, particularly given the strides hospitals have made in recent years increasing transparency for consumers and the leniency the Biden administration has shown for similar provisions covering the insurance industry.
Nevertheless, CMS finalized previously scheduled cuts to 340B providers and hospital-based outpatient departments (HOPDs), while increasing fines by 1,700% on hospitals CMS finds in violation of the Hospital Price Transparency Rule.
CMS also finalized its proposal to roll back the Trump administration policies that would have phased out the inpatient-only list while adding back most of the services that had been removed from the list in 2021.
In addition to these, CMS finalized proposals to:
- Increase overall outpatient prospective payment system (OPPS) rates by 2.0%;
- Remove or add various provisions in the Outpatient Quality Reporting Program (OQR);
- Require reporting of health care personnel vaccination rates; and
- Use CY 2019 claims data for rate-setting given the disruption of COVID-19 in 2020.
Contact WHA Vice President of Federal and State Relations
Jon Hoelter with questions.