The Centers for Medicare and Medicaid Services issued its final rule on outpatient and ambulatory surgery center payments for 2011, clearing the way for beneficiaries to receive cost-free preventive screenings.
The elimination of cost-sharing is among the provisions of the Affordable Care Act being implemented through the outpatient and ambulatory surgical center (ASC) rule.
“We know that prevention, early detection, and early treatment of diseases can promote better outcomes for patients and lower long-term health spending,” said Dr. Donald Berwick, CMS administrator.
The rule prohibits development of new physician-owned hospitals or expansion of existing physician-owned facilities.
The agency is proposing to cut payments for radiology services by 10%. The reduction is based on the assumption that imaging equipment is now being used at a higher rate to calculate payments, according to the agency.
Radiation therapy, however, received a slight bump up in pay.
Overall, the CMS estimates that it will pay $39 billion in 2011 for outpatient services, and another $4 billion for services delivered to Medicare beneficiaries in ASCs. The nation's 5,000 ASCs will be paid for the first time under a revised rate system that more closely aligns reimbursement with hospital outpatient pay.
The agency issued some new quality reporting requirements for outpatient services. Providers now have 4 new quality measures to report on, added to the 11 already required. Another eight measures will be added in 2012.