Statement on Final CY 2016 OPPS Rule
Executive Vice President Government Relations and Public Policy
American Hospital Association
October 30, 2015
We are deeply disappointed that CMS today finalized their negative update for hospital outpatient services for patient care. It is unfortunate that hospitals and the patients they serve are now left to deal with the consequences of CMS’ faulty math. We continue to be troubled by CMS’ actuaries’ lack of transparency, which is untenable.
However, we are pleased to see that the agency finalized its changes to the two-midnight policy. Hospitals appreciate the certainty that stays of at least two midnights are inpatient, with stays of less than two midnights also considered inpatient based on physician judgement. We look forward to working with the Quality Improvement Organizations, which are not paid on a contingency fee basis like the bounty hunter RACs, and to a more fair auditing process.
As expected, CMS deferred discussion of the 0.2% cut related to the two-midnight policy until later this year. If that reduction remains, we will continue to pursue a robust critique of CMS’ justification for the unlawful 0.2% cut.
About the AHA
The AHA is a not-for-profit association of health care provider organizations and individuals that are committed to the health improvement of their communities. The AHA is the national advocate for its members, which include nearly 5,000 hospitals, health care systems, networks, other providers of care and 43,000 individual members. Founded in 1898, the AHA provides education for health care leaders and is a source of information on health care issues and trends. For more information, visit the AHA website at www.aha.org.
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