CMS proposes paying for outpatient total joints

Editor's Note

The Centers for Medicare & Medicaid Services on July 13 issued a proposed rule that updates payment rates and policy changes in the Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System.

Among the proposals are that Medicare pay for knee replacement procedures performed in outpatient facilities, and the rule seeks comments on whether outpatient partial and total hip procedures should be eligible for Medicare reimbursement.

The move to performing total joints in outpatient settings raises questions about the future of Medicare’s mandatory Comprehensive Care for Joint Replacement bundled-payment initiative, the July 13 Modern Healthcare says.

Comments on the proposed rule are due September 11.

The CMS wants to slash 340B drug payments to hospitals and allow Medicare to pay for hip and knee replacement procedures that take place in outpatient facilities, according to a proposal released Thursday. The agency proposes paying hospitals 22.5% less than the average sales price for drugs acquired under the 340B program.