The CMS should reconsider the quality-reporting requirements, among other payment methodologies, in its proposed outpatient prospective payment system rule for 2009, the American Hospital Association wrote in a comment letter to acting CMS Administrator Kerry Weems.
The medical-imaging efficiency measures included in the outpatient rule have not been vetted through the National Quality Forum endorsement process, nor have they been adopted by the Hospital Quality Alliance. We strongly believe that measures added to the outpatient reporting program must first go through the rigorous, consensus-based assessment processes of both the NQF and HQA, according to the AHA letter.
In addition, the CMS has not adequately demonstrated that creating two cost centers for drugs, which will lead to extra resource burden on hospitals, will result in improved payment accuracy, according to the AHA. The proposed payment rate for separately covered outpatient drugs is based on a methodology that contains flaws, as well, the AHA wrote.
The association said it supports the CMS process for validating outpatient quality data and its proposal to pay for partial hospitalization program services using two new ambulatory payment classifications. -- by Jean DerGurahian