The Centers for Medicare and Medicaid Services (CMS) on July 13 released the 2024 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule. CMS proposes a 2.8% increase to OPPS payment rates that reflects a market basket update of 3.0% reduced by a productivity adjustment of 0.2%. 

Highlights from the proposed rule regarding payment policy, rate setting and other provisions include:

• Cardiac ablation services were not added to the ASC Covered Procedures List (CPL).
• Proposal to extend the productivity-adjusted hospital market basket update to ASC payment system through 2025.
• Proposal to add a separate payment under the Hospital Inpatient Prospective Payment System that establishes and maintains access to a buffer stock of essential medicines to foster a more reliable, resilient supply of these medicines, which may be considered for the OPPS in the future.
• No cardiovascular changes to the In-Patient Only list.
• No cardiovascular changes to the CPL.
• Ambulatory payment classification (APC) payments for cardiovascular care seemingly stable.
• Request for information regarding the packaging of radiopharmaceuticals into imaging payments and how that may affect patient access.
• Proposal to add 230 dental codes to clinical APCs.
• Enhanced enforcement of hospital transparency requirements.

Additional information on the proposed rule can be found in the OPPS Press Release, OPPS Fact Sheet, and a separate fact sheet on Hospital Price Transparency. ACC Advocacy staff will continue to provide more detailed information on elements of the proposed rule in the weeks ahead and develop comments for submission within the 60-day comment period. Look for updated information on ACC.org/Advocacy and in upcoming issues of The Advocate newsletter.

Not long before the final rules are released in the fall, experts will discuss federal legislative and regulatory topics at ACC Legislative Conference 2023 taking place Oct. 15-17 in Washington, DC. Don’t miss this opportunity to learn about hot button issues facing cardiologists and to ensure the voice of cardiology is heard on Capitol Hill. Access online registration here. Visit the ACC’s grassroots page for ways to advocate for the financial stability of physician practices and preserving Medicare beneficiaries’ access to care.

Clinical Topics: Cardiovascular Care Team

Keywords: Health Services Accessibility, Policy, Cardiology, Fee Schedules, Outpatients, Medicaid, Inpatients, Cardiologists, Radiopharmaceuticals, Medicare, Centers for Medicare and Medicaid Services, U.S., United States, ACC Advocacy

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