Also on November 1, CMS released several other fee schedules for calendar year 2012, accompanied by numerous rule changes and new quality measurement programs. The final rule for the Medicare Hospital Outpatient Prospective Payment System provides for an overall rate increase of 1.9%, versus the 1.5% that had been proposed. The final rule also includes a payment adjustment for designated cancer hospitals, as required by the PPACA, which is expected to increase payments to cancer hospitals by 11.3%.
Payment rates for Ambulatory Surgery Centers increased by 1.6% overall, higher than the 0.9% that had been proposed. In a new quality reporting program announced by CMS for ambulatory surgery centers, five quality measures must be reported by ASCs beginning in calendar year 2012, to be used in the payment determination for calendar year 2014.
In the final rule for the End-Stage Renal Disease Prospective Payment System, overall ESRD payment rates increased by 2.5%, slightly higher than the 2.1% that had been proposed. The new ESRD rule includes changes in quality measures for anemia management and changes to the definition of Durable Medical Equipment.
In CMS’s final rule for Home Health Prospective Payment, payments to home health agencies are expected to decrease by about 2.3%. In a statement, Val J. Halamandaris, president of The National Association for Home Care & Hospice, said, “We appreciate CMS’s willingness to work with us in phasing in the cuts to home health care, however to the 11,700 home care agencies a decrease of 2.31 percent is still a hard pill to swallow. The fact remains that the majority of home health providers will be operating in the red with this rate cut.”