CHA News Article

CMS Issues First of Two CY 2020 OPPS Final Rules
For CEOs, CFOs, government relations staff, finance & reimbursement staff

The Centers for Medicare & Medicaid Services (CMS) has issued the first of two separate regulations finalizing provisions for the calendar year (CY) 2020 outpatient prospective payment system. In the first final rule, released today, CMS raises hospital outpatient payments by 2.6% for CY 2020 and estimates this will increase overall outpatient payments by $6.3 billion compared to CY 2019.

CHA is currently reviewing the provisions of the final rule including the agency’s next steps in implementation of site-neutral payment for hospital outpatient departments and reduced payments for 340B drugs – both of which have been found to be invalid by the court.

In addition, CMS has finalized its proposal to adopt the FFY 2020 area wage index policies outlined in the inpatient prospective payment system final rule.  

Notably, the Office of Management & Budget is still reviewing a separate final rule on the price transparency requirements that were outlined as part of the proposed rule.  Because the price transparency proposals were part of the president’s executive order, there is no statutory deadline for implementation. CMS has flexibility on the timing of finalization and implementation of these policies. 

CHA vigorously opposed the inpatient area wage index policies as well as the price transparency proposals that require release of hospitals’ confidentially negotiated rates for all payors for designated items and services. The CMS fact sheet is attached.

When CHA has reviewed the final rule, additional details will be provided in CHA News in the coming weeks. 

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