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Four Final Rules Affecting CMS Payments for 2018

November 7th, 2017 - Wyn Staheli
Categories:   Medicare   Reimbursement  
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It’s a season for changes. CMS just finalized four rules which directly impact the following payment systems:

  1. Physician Fee Schedule Final Policy, Payment, and Quality Provisions for CY 2018
  2. Hospital OPPS and ASC Payment System and Quality Reporting Programs Changes for 2018
  3. HHAs: Payment Changes for 2018
  4. Quality Payment Program Rule for Year 2

1. Physician Fee Schedule

This final rule includes a new Patients over Paperwork initiative, RVU changes, expansion of the Diabetes Prevention Program and much more. When considering fees, always keep in mind that fees are always adjusted based on quality program initiatives. The final conversion factor for 2018 is set as $35.99 (an increase from $35.89 for 2017). The Final Rule includes the following:

CLICK HERE to read the Press Release.

CLICK HERE to read the Final Rule.

2. Hospital OPPS and ASC Payment System and Quality Reporting Programs

For 2018, CMS is increasing the hospital OPPS rate by 1.35 percent and ASC payments are projected to increase approximately 3 percent. The Final Rule includes the following:

CLICK HERE to read the Press Release.

CLICK HERE to read the Final Rule.

3. HHAs: Payment Changes

For 2018, CMS projects a decrease of 0.4 percent in payments to Home Health Agencies (HHAs) which includes the sunsetting of the rural add-on provision. The Final Rule includes the following:

CLICK HERE to read the Press Release.

CLICK HERE to read the Fact Sheet.

CLICK HERE to read the Final Rule.

4. Quality Payment Program Rule for Year 2

CMS kept some of the transition year policies and made some other changes designed to reduce the burden of provider participation. The Final Rule includes:

CLICK HERE to read the Final Rule Overview.

CLICK HERE to read the Executive Summary.

CLICK HERE to read the Press Release.

CLICK HERE to read the Final Rule.

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