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CMS Proposed OPPS Rule

On July 19 the Centers for Medicare & Medicaid Services (CMS) released a proposed rule for 2022, regarding the Outpatient Prospective Payment System (OPPS). The CMS rule would increase Medicare hospital OPPS rates by a net 2.3% from 2021. CMS estimates this increase will make next year’s total payments to OPPS providers $82.7 billion.

Additionally, the proposed rule would continue to cut 340B drug payments, a proposed 22.5% less than the average sales price for 340B drugs. The new rule proposes reversing a 2021 rule to phase out inpatient-only lists by adding back the 298 previously removed services from the inpatient-only list for 2022. The CMS rule also bans special coding that hides pricing from showing up in search engine results.

CMS is also now requesting stakeholder feedback and public comments regarding the establishment of the Rural Emergency Hospitals provider type.

To read the proposed rule click here.

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