Outpatient PPS

Dec 4, 2018
The AHA, jointly filed a lawsuit against the Department of Health and Human Services for finalizing a policy to phase-in a reduction in payments for hospital outpatient clinic visit services furnished in off-campus provider-based departments that are grandfathered under Section 603 of the…
Feb 21, 2020
The AHA, joined by the Association of American Medical Colleges and a number of member hospitals, filed a brief urging the U.S. Court of Appeals for the District of Columbia Circuit to affirm a district court ruling that voided the Centers for Medicare…
Feb 11, 2020
The U.S. Court of Appeals for the D.C. Circuit will hear oral arguments April 17 in the Department of Health and Human Services’ appeal of a district court ruling in favor of the AHA and hospital organizations that found the agency could not reduce calendar year 2019 payments for hospital…
Feb 10, 2020
President Trump today submitted to Congress his budget request for fiscal year 2021.
Jan 30, 2020
The Centers for Medicare & Medicaid Services has identified the Healthcare Common Procedure Coding System billing codes for hospital outpatient services that will require prior authorization starting July 1 under the hospital outpatient prospective payment system final rule for calendar year 2020.
Jan 27, 2020
HPA spreadsheets for relative weights and payment rates for the hospital outpatient prospective payment system (OPPS) comparing 2020 to 2019 rates.  There are two spreadsheets, one based on APC-level comparisons and the other on HCPCS-level comparisons. 
Jan 14, 2020
The Medicare Payment Advisory Commission (MedPAC, or the Commission) will vote this month on payment recommendations for 2021. The American Hospital Association (AHA) asks that commissioners consider the following issues that would have a significant impact on hospitals, health systems, other…
Jan 13, 2020
The AHA, joined by Association of American Medical Colleges and several member hospitals, today filed a lawsuit against the Department of Health and Human Services for continuing to reduce in calendar year 2020 payments for hospital outpatient services provided in off-campus provider-based…
Dec 13, 2019
The Department of Health and Human Services Dec. 12 announced that it intends to ask the U.S. Court of Appeals to reverse a district court ruling in favor of the AHA.