Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Procurement Organizations; Quality Improvement Organizations; Electronic Health Records (EHR) Incentive Program; Provider Reimbursement Determinations and Appeals
This proposed rule would revise the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2014 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this proposed rule, we describe the proposed changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this proposed rule would update and refine the requirements for the Hospital Outpatient Quality Reporting (OQR) Program, the ASC Quality Reporting (ASCQR) Program, and the Hospital Value-Based Purchasing (VBP) Program. We are proposing changes to the conditions for coverage (CfCs) for organ procurement organizations (OPOs); revisions to the Quality Improvement Organization (QIO) regulations; changes to the Medicare fee-for-service Electronic Health Record (EHR) Incentive Program; and changes relating to provider reimbursement determinations and appeals.
Additional Resources and Downloads:
CMS-1601-P (Published 07/19/2013)
- 2014 OPPS NPRM Claims Accounting [PDF, 147KB]
- 2014 OPPS NPRM Cancer Adjustment Analysis File [ZIP, 243KB]
2014 OPPS NPRM Rev Code to Cost Center Crosswalk
2014 OPPS NPRM Cost Statistics Files – Updated 8/5/13
2014 OPPS NPRM Facility-Specific Impacts – Updated 8/5/13
2014 OPPS NPRM Blood Revenue Code Cost to Charge Ratios
Proposed Changes to the Ambulatory Surgical Center Payment System and CY 2014 Payment Rates
CORRECTION and Limited Extension for Comment Period Through September 16, 2013
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