CMS issues hospital outpatient, ambulatory surgical center pay rule

Mississippi lawmakers consider easing restrictions on public hospitals

Hospitals are set to receive a 2.8% increase in Medicare reimbursements for outpatient care in calendar 2024 under a proposed rule the Centers for Medicare and Medicaid Services issued Thursday.

The American Hospital Association characterized the outpatient reimbursement increase as insufficient.

“Without a more robust payment update in the final rule, hospitals’ and health systems’ ability to continue caring for patients and providing essential services for their communities may be jeopardized,” Executive Vice President Stacey Hughes said in a news release. “Most hospitals across the country continue to operate on negative or very thin margins that make providing care and investing in their workforce very challenging day to day.”

The draft regulation includes provisions designed to increase access to behavioral healthcare by creating a new benefit category called the Intensive Outpatient Program to cover mental health services for Medicare beneficiaries who may need frequent but less intensive care than provided at psychiatric hospitals.

The new benefit would cover services for patients diagnosed with acute mental illnesses or substance use disorder who receive care in hospital outpatient departments, community mental health centers, federally qualified health centers and rural health clinics. The regulation also proposes updated Medicare payment rates for the partial hospitalization program, an alternative to psychiatric hospitalization.

“CMS is taking action to help shape a resilient, equitable and high-value healthcare system,” CMS Administrator Chiquita Brooks-LaSure said in a news release.

The proposed rule also would modify CMS’ hospital price transparency initiative. CMS seeks to change the standard charge display requirements and update enforcement terms. Hospitals would have to disclose standard charges data using a CMS template while also encoding standard charge information.

The draft regulation calls for a 2.8% increase in Medicare reimbursements to ambulatory surgical centers.

CMS will accept comments on the proposed rule through Sept. 11. The final rule is expected in November.

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Marie Maynes
Marie Maynes is a Sports enthusiast and writes for the Sports section of ANH.