2021-15496: Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Price Transparency of Hospital Standard Charges; Radiation Oncology Model; Request for Information on Rural Emergency Hospitals

Summary

This proposed rule would revise the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for Calendar Year (CY) 2022 based on our continuing experience with these systems. In this proposed rule, we describe the proposed changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. Also, this proposed rule would update and refine the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program, update Hospital Price Transparency requirements, and update and refine the design of the Radiation Oncology Model. Finally, this proposed rule includes a Request for Information (RFI) focusing on the health and safety standards, quality measures and reporting requirements, and payment policies for Rural Emergency Hospitals (REHs), a new Medicare provider type. The RFI will be used to inform future rulemaking for REHs.

The agency’s own summary, as published.

What this changes

Amends 5 parts of the Code of Federal Regulations — the standing rules this notice rewrites.

• 42 CFR 412 Prospective Payment Systems for Inpatient Hospital Services
• 42 CFR 416 Ambulatory Surgical Services
• 42 CFR 419 Prospective Payment Systems for Hospital Outpatient Department Services
• 42 CFR 512 Standard Provisions for Mandatory Innovation Center Models and Specific Provisions for Certain Models
• 45 CFR 180 Hospital Price Transparency