The CMS issued an interim final rule for hospital outpatient services that is consistent with the recently enacted Medicare law. The interim final rule replaces rules originally published in November. The new measure extends for two years special payments to rural hospitals; the payments ensure that rural hospitals receive at least as much under the outpatient prospective payment system as they did under the prior cost-based system, and they had been scheduled to end Jan. 1, 2004. About 1,000 small rural and community hospitals will be eligible for these payments. Medicare also will change the way it pays for radiopharmaceuticals, drugs and biologicals in the outpatient setting when those drugs are no longer eligible for temporary additional payments known as pass-throughs. Drugs with pass-through status will be reimbursed at 85% of the average wholesale price (AWP) if the Food and Drug Administration approved the drug before April 1, while those approved on or after that date will be reimbursed at 95% of the AWP. Brachytherapy sources will be paid on a cost basis. The rule takes effect Jan. 1 and will be published in the Jan. 6 Federal Register. -- by Tony Fong
CMS issues new rule on outpatient PPS
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