2016 OPPS Rule Changes

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2016 OPPSRule ChangesMaggie Fortin, CPC, CPC-H, CHCSenior ManagerJanet Hodgdon, CPA, CPCDirectorDecember 2015OPPS -Talking points2 CMS Objectives-Incentivize efficient care-Reduce administrative burden for more accuracy of payment Achieve long-term goal to create a single prospective payment for the entire outpatient encounter by packaging payment for all C APC servicesALSO:Statutory reduction for failure to meet quality reporting of 2%Wage index to be used will be final IPPSOVERALL DECREASE IN PAYMENTS ESTIMATED AT $133 MILLIONMarket Productivity(.5)%ACA(.2)%Packaged lab issue( )%Overall update(.3)%Final Payment UpdatesSCH rural adjustment for outpatient continues at , biologicals and radio-pharmaceuticals are set at the ASP plus 6%Other Updates and AdjustmentsOPPS Operational Updates5OPPSIn the 2016 OPPS rule change we continue to see CMS implementing Changes to this ever-evolving complex payment system CMS continues to revise the packag

2016 OPPS Rule Changes Maggie Fortin, CPC, CPC -H, CHC Senior Manager Janet Hodgdon, CPA, CPC Director December 2015

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