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To Add Or Not To Add APCs: Orthopedic Alliance Clashes With MedPAC

This article was originally published in The Gray Sheet

Executive Summary

MedPAC's recommendation that CMS reduce the number of existing APCs in the hospital outpatient prospective payment system is at odds with orthopedics manufacturers' requests

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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 Panel Meeting Will Allow Manufacturers To Address OPPS Payment Cuts

CMS does not intend to adjust median costs for ambulatory payment classification (APC) groups in the 2004 hospital outpatient prospective payment system update, despite 54 device-related categories facing payment cuts in excess of 10%

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