AHA comments on proposed outpatient payment rule for CY 2023

Commenting today on the Centers for Medicare & Medicaid Services’ proposed calendar year 2023 payment rule for hospital outpatients and ambulatory surgical centers, AHA said it supports the agency’s decision to end its unlawful cuts to 340B hospitals and urged the agency to promptly restore 340B hospital payments for CYs 2018-2022 without penalizing other hospitals. AHA also voiced support for the agency’s proposal to use Medicare claims data to calculate the monthly facility rate for Rural Emergency Hospitals, and urged the agency to detail the payment methodology and monitor its adequacy going forward. 
 
However, AHA strongly urged the agency to increase the rule’s proposed market basket update and reduce its productivity adjustment to reflect the unprecedented inflationary environment hospitals and health systems are experiencing. It also urged CMS not to add facet joint interventions to its prior authorization process, as other oversight mechanisms are available that do not delay appropriate care. 
 
Among other issues, AHA commented on CMS’s proposal to exempt rural Sole Community Hospitals from the site-neutral clinic visit payment cuts; organ acquisition payments; and a request for information regarding the use of CMS data to drive competition in health care marketplaces.