Health Information Management

Topic: Experts feel 2008 OPPS final rule contains radical changes

HIM-HIPAA Insider, November 20, 2007

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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. The final rule introduces the new concept of composite APCs, which, in certain circumstances, provide a single payment to cover services across an entire patient encounter.

This is the first year that hospitals have seen a drastic 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.

"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."

Editor's note: To view the 2008 OPPS final rule, click here.

This topic was adapted from on the November issue of For more information, click here.

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