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OPPS Stability Requires 5% Floor In Cuts To Device APCs – AdvaMed, MDMA

This article was originally published in The Gray Sheet

Executive Summary

With 17 device-related APCs facing at least a 50% payment reduction from their 2002 rates, AdvaMed is asserting the need for a 5% floor on reductions in the 2004 hospital OPPS final rule

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2004 Hospital Outpatient Prospective Payment System Final Rule In Brief

CMS to consider APC Advisory Panel scheduling concerns: Panel members' receipt of device-related materials before their Aug. 22 meeting compensates for the one-hour time period devoted to device issues, according to the Nov. 7 1OPPS final rule. CMS maintains it provided ample notice by first announcing the meeting date July 25 and placing the proposed rule on display Aug. 6 - early enough for a wealth of "thoughtful comments" from "interested parties" to be presented. The explanation responds to device industry criticism that the meeting was held too soon after publication of the Aug. 12 proposed rule (2"The Gray Sheet" Oct. 6, 2003, p. 8). Nonetheless, CMS will "take this comment into consideration"...

2004 Hospital Outpatient Prospective Payment System Final Rule In Brief

CMS to consider APC Advisory Panel scheduling concerns: Panel members' receipt of device-related materials before their Aug. 22 meeting compensates for the one-hour time period devoted to device issues, according to the Nov. 7 1OPPS final rule. CMS maintains it provided ample notice by first announcing the meeting date July 25 and placing the proposed rule on display Aug. 6 - early enough for a wealth of "thoughtful comments" from "interested parties" to be presented. The explanation responds to device industry criticism that the meeting was held too soon after publication of the Aug. 12 proposed rule (2"The Gray Sheet" Oct. 6, 2003, p. 8). Nonetheless, CMS will "take this comment into consideration"...

APC Floor Will Not Be Applied To Devices, But C-Codes Are Back – OPPS Rule

The payment rates for five device-related APCs will be raised from their 2004 proposed rates through the use of external data, but CMS will not apply a dampening mechanism for APCs falling in excess of 5%, according to the 12004 OPPS final rule

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