News & Analysis as of

Outpatient Prospective Payment System (OPPS) Rural Health Care Providers

Holland & Knight LLP

CMS Releases CY 2026 Outpatient Prospective, ASC Payment System Proposed Rule

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The Centers for Medicare & Medicaid Services (CMS) on July 15, 2025, issued the Hospital Outpatient Prospective Payment (OPPS) and Ambulatory Surgical Center (ASC) Payment Systems proposed rule, which proposes updates to the...more

King & Spalding

CMS Issues CY 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final...

King & Spalding on

On November 1, 2024, CMS issued a final rule with updates to the Medicare payment rates for the Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) Payment System for...more

Holland & Knight LLP

CMS Releases CY 2025 OPPS and ASC Final Rule

Holland & Knight LLP on

The Centers for Medicare & Medicaid Services (CMS) has released the calendar year (CY) 2025 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule with comment...more

King & Spalding

CMS Issues Revised Guidance Regarding Enrollment and Conversion Process for Rural Emergency Hospitals

King & Spalding on

On September 6, 2024, CMS released revised guidance regarding the process by which rural hospitals and outpatient facilities can participate in Medicare as a Rural Emergency Hospital (REH) rather than a Critical Access...more

Butler Snow LLP

Rural Emergency Hospitals: Relief for the Weary?

Butler Snow LLP on

On December 27, 2020, the Centers for Medicare & Medicaid (“CMS”) of the Department of Health and Human Services created a new provider type for embattled rural and critical access hospitals (“CAHs”)—the Rural Emergency...more

K&L Gates LLP

Rural Emergency Hospitals: CMS Finalizes Key Policies for New Medicare Provider Type (Part 2 of 2)

K&L Gates LLP on

On 1 November 2022, the Centers for Medicare & Medicaid Services (CMS) published the 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule (the OPPS Final...more

K&L Gates LLP

Rural Emergency Hospitals: CMS Finalizes Key Policies for New Medicare Provider Type (Part 1 of 2)

K&L Gates LLP on

On 1 November 2022, the Centers for Medicare & Medicaid Services (CMS) published the 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule (the OPPS Final...more

King & Spalding

CMS Issues Outpatient Prospective Payment System Final Rule for CY 2023

King & Spalding on

On November 1, 2022, CMS published a final rule to update the payment policies, payment rates, and other provisions for services furnished under the Medicare Outpatient Prospective Payment System (OPPS) and the Ambulatory...more

Holland & Knight LLP

CMS Releases 2023 Hospital OPPS and ASC Payment System Final Rule

Holland & Knight LLP on

The Centers for Medicare & Medicaid Services (CMS) on Nov. 1, 2022, released the calendar year (CY) 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule...more

K&L Gates LLP

Rural Emergency Hospitals: CMS Publishes Proposed Enrollment and Payment Policies for New Medicare Provider Type

K&L Gates LLP on

On 26 July 2022, the Centers for Medicare & Medicaid Services (CMS) published the 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule (the OPPS Proposed...more

McDermott Will & Emery

CMS Proposes Key Details for Payment Methodology, Quality Measures and Enrollment Policies for Rural Emergency Hospitals

McDermott Will & Emery on

Rural emergency hospitals (REHs) are a new Medicare provider type that will allow Medicare to pay for emergency department and other outpatient hospital services in rural areas beginning on January 1, 2023, without requiring...more

Holland & Knight LLP

CMS Releases CY 2023 Outpatient and ASC Payment System Proposed Rule

Holland & Knight LLP on

The Centers for Medicare & Medicaid Services (CMS) has released the calendar year (CY) 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Proposed Rule (CMS-1772-P),...more

Husch Blackwell LLP

CMS Releases CY 2023 OPPS and ASC Proposed Rule

Husch Blackwell LLP on

The Centers for Medicare and Medicaid Services (CMS) issued the calendar year (CY) 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Proposed Rule on July 15, 2022. The Proposed...more

Holland & Knight LLP

CMS Releases CY 2022 OPPS and ASC Proposed Rule

Holland & Knight LLP on

The Centers for Medicare & Medicaid Services (CMS) on July 19, 2021, released its calendar year (CY) 2022 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Proposed...more

McDermott Will & Emery

Congress Establishes New Medicare Provider Category and Reimbursement for Rural Emergency Hospitals

Year-end COVID-19 relief legislation approved by Congress established Rural Emergency Hospitals (REHs) as a new Medicare provider type effective January 1, 2023. REHs, defined as providers that furnish certain outpatient...more

King & Spalding

CMS Publishes Final Rule for CY 2020 Hospital Outpatient Prospective Payment System

King & Spalding on

n November 1, 2019, CMS posted the final rule establishing the payment rates for the Hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgery Center (ASC) Payment System for calendar year (CY) 2020...more

Holland & Knight LLP

CMS Issues 2020 Hospital OPPS and ASC Payment System Final Rule

Holland & Knight LLP on

The Centers for Medicare & Medicaid Services (CMS) on Nov. 1, 2019, released the Calendar Year (CY) 2020 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule....more

Baker Donelson

Agency's About-Face: CMS Proposes Changes to Supervision Rules for Hospital Outpatient Therapeutic Services

Baker Donelson on

Among the many provisions in the FY 2020 Outpatient Prospective Payment System (OPPS) proposed rule is one that would alter the supervision standards applicable to hospital outpatient therapeutic services. See 84 Fed. Reg....more

Baker Donelson

Court Rules HHS 340B Payment Cuts Unlawful; HHS Seeks Stay in Proceedings

Baker Donelson on

In an opinion issued December 27, 2018, a Federal District Court ruled that the Department of Health & Human Services (HHS) exceeded its authority by reducing Part B drug reimbursement to certain hospitals in the 340B drug...more

Baker Donelson

CMS Proposes More Payment Changes for 340B Hospitals in 2019

Baker Donelson on

The Medicare program is once again looking to reduce payments to 340B hospitals for Part B drugs and biologicals. As part of its proposed payment regulation for hospitals under the Outpatient Prospective Payment System (OPPS)...more

Baker Donelson

CMS Issues Updated Medicare Payment and Billing Policies for 340B Hospitals

Baker Donelson on

On April 2, 2018, CMS issued updated guidance related to the dramatic Medicare payment reductions that went into effect this year for certain 340B hospitals. The guidance explains the planned application of the payment cuts...more

Dorsey & Whitney LLP

Medicare Proposes Continued Relief for Critical Access and Rural Hospitals Through 2-Year Moratorium on Direct Supervision...

Dorsey & Whitney LLP on

On July 13, 2017, CMS released a proposed rule as part of its 2018 Outpatient Prospective Payment System proposals that is aimed at helping to reduce some of the burdens rural hospitals experience in recruiting physicians....more

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