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CMS releases 2008 OPPS final rule

Patient Financial Services Weekly Advisor, November 9, 2007

In addition to finalizing most of its proposals, CMS created a new type of APC in its 2008 OPPS final rule (CMS-1392-FC) released Thursday, November 1. The rule takes effect on January 1, 2008.

This is the first year hospitals have seen a radical change to packaging and other methodologies to control the rapidly growing healthcare expenditures under OPPS, says William L. Malm, ND, practice director of revenue cycle management at HCPro, Inc., in Marblehead, MA. The final rule introduces the new concept of composite APCs, which in certain circumstances provide a single payment to cover services across the entire patient encounter.

"This final rule appears to contain the most radical changes to OPPS payment policy since its inception in August 2000," says Jugna Shah, MPH, president of Nimitt Consulting in Washington, DC. "Some of the changes are positive, but many others are likely to result in significant financial and operational impact for providers."

To read the full story in HCPro Inc.'s HealthLeaders Media, click here.

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