American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

CMS Releases FY 2020 IPPS Final Rule

The Centers for Medicare & Medicaid Services (CMS) August 2 issued the fiscal year (FY) 2020 Medicare Inpatient Prospective Payment System (IPPS) final rule. Under the provisions in this rule, CMS projects a $3.8 billion increase in total Medicare Part A spending on inpatient hospital services furnished October 1, 2019, to September 30, 2020.

The final rule states that CMS will conduct a comprehensive review of its process for determining whether certain surgical procedures should be classified as operating room (OR) services—which are reimbursed at a higher rate than non-OR services—for the purposes of IPPS payment. CMS will consider a number of factors, including Medicare claims data and relative resource requirements for various services, in an effort to better recognize the complexity and costs of surgical procedures. The agency also finalized a policy to provide additional reimbursement for certain new medical devices and technologies. The American College of Surgeons has supported such add-on payments for new devices and technologies under the IPPS to reduce financial barriers to investment and adoption by hospitals.

In addition, CMS further aligned requirements between the Medicare and Medicaid Promoting Interoperability and the Hospital Inpatient Quality Reporting programs and will continue to streamline all hospital-based quality reporting programs. The agency indicated its continued focus on opioid prescribing and pain management best practices by finalizing the inclusion of several new quality measures. CMS did not finalize policies regarding open-source standards for data exchange, as these will be part of the final rules from the 21st Century Cures Act.

The final rule and related fact sheet are available online for public review. If you have any questions, contact regulatory@facs.org.

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