Federal health regulators want to increase hospital outpatient payments by 2.7% for 2023, an increase of about $6.2 billion in Medicare payments from this year.
Yet, the American Hospital Association is "deeply concerned" about the proposed Medicare payment rate amid increased inflation.
"A much higher update is warranted," AHA Executive Vice President Stacey Hughes said in a Friday statement following the release of the proposed 2023 Hospital Outpatient Prospective Payment System rule.
The proposed rule will affect more than 3,400 hospitals and roughly 5,500 ambulatory surgery centers, the CMS said.
The regulation also includes many new proposed payment policies aimed at rural hospitals, remote behavioral health services and N-95 respirators made in the U.S.
Building on an earlier proposal to aid rural providers, the CMS released payment proposals for hospitals seeking the new rural emergency hospital designation.
These hospitals would see a 5% higher payment rate above the standard outpatient rate in an effort to maintain access to services in rural areas, the CMS said.
The CMS also is seeking to make permanent reimbursement for remote behavioral health services. Payment for providing behavioral health services to patients in their homes was set to expire at the end of the public health emergency.
The rule also creates an incentive for providers to purchase N-95 respirators that are made in the U.S.
Under the proposed rule, providers would receive additional payments for these purchases as the CMS recognizes domestically made protective equipment can be more costly.
Following a recent decision from the Supreme Court in favor of hospitals, the CMS said it plans to change its payments to hospitals in the 340B drug program to average sale price plus 6%. The agency was paying the average sales price minus 22.5%, which providers argued in court amounted to a $1.6 billion annual cut.
“This is an important step toward reversing the damage caused by deep cuts to payments for outpatient drugs acquired through the 340B Drug Pricing Program — cuts the U.S. Supreme Court unanimously found unlawful,” Beth Feldpush, senior vice president of policy and advocacy for America’s Essential Hospitals, said in a statement.
In addition to payment changes, the agency is proposing to remove 10 procedures from the inpatient-only list, including arthrodesis, a procedure that fuses together two bones to alleviate joint pain.
Stakeholders have until Sept. 13 to comment on the proposed rule. The CMS expects to issue the final rule in early November.