Medicare Releases 2022 Hospital OPPS/ASC Proposed Rule

On July 19, CMS released the 2022 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment proposed rule. The agency plans to increase hospital outpatient and ACS payment rates by 2.3%. Hospitals and ASCs that fail to meet their quality reporting program requirements would also be subject to a 2.0% reduction in the update. Also, CMS proposes to halt the elimination of the Inpatient Only (IPO) list. In 2020, there were 1,740 services on the IPO list. In 2021, CMS initiated a three-year transition to eliminate the IPO list, beginning with 298 mostly musculoskeletal-related services. If CMS finalizes this policy, these 298 services will be added back to the IPO list in 2022. In addition, CMS proposes to re-adopt the ASC Covered Procedures List (CPL) criteria in effect in 2020 and changed last year. The agency would also remove 258 of the 267 procedures added to the ASC CPL in 2021.

The reversals are in keeping with previous AANS and the CNS comments where we emphasized that the site of service should be determined by the surgeon and patient, not CMS. In last year’s comment letter, the neurosurgical groups raised patient safety concerns and worried that CMS would make it difficult to access the inpatient setting when necessary.

Click here to read the proposed rule, here for the press release and here for a fact sheet.