CMS Issues Proposed Rule for CY 2011 Outpatient Prospective Payment System - July 7, 2010

On July 2, the Centers for Medicare & Medicaid Services (CMS) released the outpatient prospective payment system proposed rule for Calendar Year 2011. The proposed rule will be published in the Federal Register on August 3, 2010, and comments are due by August 31, 2010. NAPH is reviewing the 1,600-page proposed rule and have identified the following issues that are particularly important to NAPH members:

• implementation of health reform-mandated changes to graduate medical education payments to include resident time in non-provider settings and resident time for didactic and scholarly activities
• implementation of the health reform law’s resident cap redistribution provision that redistributes 65 percent of unused residency slots to eligible hospitals in Alabama, Alaska, Arizona, the District of Columbia, Florida, Georgia, Idaho, Indiana, Louisiana, Mississippi, Montana, Nevada, New Mexico, North Dakota, Puerto Rico, South Dakota, and Wyoming
• proposal to allow general supervision for a limited set of “nonsurgical extended duration therapeutic services” after an initiation period with direct supervision
• market basket update factor of 2.15 percent for hospitals that meeting the requirements of the Hospital Outpatient Quality Data Reporting Program (HOP QDRP) and -0.15 percent update for those that do not
• expansion of HOP QDRP for CY 2012 to 2014 payment determinations