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The Centers for Medicare and Medicaid Services (CMS) has had a regulatory fire sale over the past few days. AHPA is currently reviewing the most recently released proposed regulations, which oversee payments in outpatient departments, physicians’ offices, and home health.
CY 2025 OPPS Proposed Rule Released
CMS released their proposed Medicare payment policies for hospital outpatient services and Ambulatory Surgical Centers (ASCs). In addition to their annual payment updates, the
proposed rule lays out a new obstetrical services Conditions of Participation (CoP), new quality assessment requirements, baseline staffing and care standards, and annual staff trainings requirements on maternal health. In its continued effort to advance health equity, CMS proposes new payments and exceptions aimed at improving access to care for indigenous communities, tribal hospitals, and rural communities at large. For CMS’ summary of the proposal,
click here. AHPA plans to submit comments in response to the rule. Please reach out to
Thomas.Melton@AdventHealth.com to share any feedback and recommendations.
CY 2025 PFS Proposed Rule Released
The Agency also released its CY 2025
Physician Fee Schedule (PFS) proposed rule. Average payment rates under the PFS are proposed to decrease by 2.93% in CY 2025 compared to CY 2024. CMS also proposes to add services to its Medicare telehealth provisional and permanent lists, as well as make additional changes to the Medicare Shared Savings programs. To read CMS’ summary of the proposal, click
here. AHPA plans to submit comments in response to the rule. Please reach out to
Brandon.Cook@AdventHealth.com to share any feedback and recommendations.
CY 2025 HH PPS Proposed Rule
CMS’ Home Health (HH) prospective payment system
proposed rule would reduce HH payments by approximately $280 million, adopt new Core-Based Statistical Areas (CBSAs) for wage index determinations, and add a new CoP that would require HH agencies to develop and implement a “patient acceptance to service” policy. This would be applied consistently to each prospective patient referred for home health care. To read CMS’ proposed summary,
click here. Please reach out to
Brandon.Cook@AdventHealth.com to share any feedback and recommendations.
