CY15 OPPS Final Rule Fact Sheet

The Centers for Medicare & Medicaid Services (CMS) released a final rule with comment period updating payment policies and rates for services furnished to Medicare beneficiaries in hospital outpatient departments and establishing payments for services furnished in ambulatory surgical centers (ASCs) beginning in calendar year (CY) January 1, 2015. In addition, CMS finalizes changes to the data sources used for expansion requests for physician-owned hospitals, changes to the underlying authority for the requirement of an admission order for all hospital inpatient admissions, the requirement of inpatient admission orders only for long-stay and outlier cases, and the establishment of a three-level appeals process for Medicare Advantage (MA) organizations and Part D sponsors that will be applicable to CMS-identified overpayments. The updated rates do not encorporate the impact of the 2 percent sequestration cuts implemented by Congress to reduce the federal deficit.