United States Government Publishing Office publisher pbl distributor dst United States National Archives and Records Administration Office of the Federal Register author aut Government Organization text government publication eng FR Regulatory Information 2012_register executive 2012-11-15 article Part II Rules and Regulations D09002ee1c7fc30e3 D09002ee1c7fc31d7 United States Department of Health and Human Services originator org United States Government Agency or Subagency United States Centers for Medicare & Medicaid Services originator org United States Government Agency or Subagency This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2013 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the 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 final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program, the ASC Quality Reporting (ASCQR) Program, and the Inpatient Rehabilitation Facility (IRF) Quality Reporting Program. We are continuing the electronic reporting pilot for the Electronic Health Record (EHR) Incentive Program, and revising the various regulations governing Quality Improvement Organizations (QIOs), including the secure transmittal of electronic medical information, beneficiary complaint resolution and notification processes, and technical changes. The technical changes to the QIO regulations reflect CMS' commitment to the general principles of the President's Executive Order on Regulatory Reform, Executive Order 13563 (January 18, 2011). 77 FR 68210 https://www.govinfo.gov/app/details/FR-2012-11-15/2012-26902 2012-26902 fr15no12-16 RIN 0938-AR10 4120-01-P CMS-1589-FC https://www.govinfo.gov/app/details/FR-2012-11-15/2012-26902 https://www.govinfo.gov/content/pkg/FR-2012-11-15/html/2012-26902.htm https://www.govinfo.gov/content/pkg/FR-2012-11-15/pdf/2012-26902.pdf Health Facilities Health Professions Medicare Reporting and Recordkeeping Requirements Hospitals Health Care Health Professional Health Record Peer Review Organization (Pro) Penalties Privacy Administrative Practice and Procedure Peer Review Organizations (Pro) Health Records Computer Technology Electronic Health Records Electronic Transactions Health Health Information Technology Health Insurance Laboratories Medicaid Public Health Security 356 p. 68210 68565 77 FR 68210 Title 42 Part 416 42 CFR Part 416 Title 42 Part 419 42 CFR Part 419 Title 42 Part 476 42 CFR Part 476 Title 42 Part 478 42 CFR Part 478 Title 42 Part 480 42 CFR Part 480 Title 42 Part 495 42 CFR Part 495 RIN 0938-AR10 Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Electronic Reporting Pilot; Inpatient Rehabilitation Facilities Quality Reporting Program; Revision to Quality Improvement Organization Regulations; Federal Register Vol. 77, Issue RULE 2012-26902 II DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services CMS-1589-FC 4120-01-P 2012-26902 Final rule with comment period.

This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2013 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the 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 final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program, the ASC Quality Reporting (ASCQR) Program, and the Inpatient Rehabilitation Facility (IRF) Quality Reporting Program. We are continuing the electronic reporting pilot for the Electronic Health Record (EHR) Incentive Program, and revising the various regulations governing Quality Improvement Organizations (QIOs), including the secure transmittal of electronic medical information, beneficiary complaint resolution and notification processes, and technical changes. The technical changes to the QIO regulations reflect CMS' commitment to the general principles of the President's Executive Order on Regulatory Reform, Executive Order 13563 (January 18, 2011).

Effective Date: This final rule with comment period is effective on January 1, 2013. Marjorie Baldo, (401) 786-4617, for issues related to new CPT and Level II HCPCS codes, exceptions to the 2 times rule, and new technology APCs. Health Facilities Health Professions Medicare Reporting and Recordkeeping Requirements Hospitals Health Care Health Professional Health Record Peer Review Organization (Pro) Penalties Privacy Administrative Practice and Procedure Peer Review Organizations (Pro) Health Records Computer Technology Electronic Health Records Electronic Transactions Health Health Information Technology Health Insurance Laboratories Medicaid Public Health Security Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Electronic Reporting Pilot; etc. , IRF.questions@cms.hhs.gov OIRAsubmissions_@omb.eop.gov http://fido.gov/facadatabase/public.asp http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt.page http://www.ama-assn.org/resources/doc/cpt/cpt-corrections.pdf http://www.cdc.gov/nhsn/PDFs/pscManual/7pscCAUTIcurrent.pdf http://www.cms.gov/ASCPayment/downloads/NTIOLprocess.pdf http://www.cms.gov/FACA/05_AdvisoryPanelonAmbulatoryPaymentClassificationGroups.asp http://www.cms.gov/FACA/05_AdvisoryPanelonAmbulatoryPaymentClassificationGroups.asp#TopOfPage http://www.cms.gov/IRF-Quality-Reporting/ http://www.cms.gov/Medicare/Coding/OutpatientCodeEdit/index.html http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Part-B-Drugs/McrPartBDrugAvgSalesPrice/index.html http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/index.html http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ASCPayment/11_Addenda_Updates.html http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ASCPayment/ASC-Regulations-and-Notices.html http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ASCPayment/ASC-Transmittals-Items/ASC-CR7754-R2425CP.html http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ASCPayment/Downloads/C_ASC_RTC-2011.pdf 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http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/IRF-Quality-Reporting/index.html?redirect=/IRF-Quality-Reporting/ http://www.cms.gov/OutpatientCodeEdit/02OCEQtrReleaseSpecs.asp#TopOfPage http://www.cms.gov/Regulations-and-Guidance/Guidance/FACA/AdvisoryPanelonAmbulatoryPaymentClassificationGroups.html http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c04.pdf http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R17QIO.pdf http://www.cms.gov/Research-Statistics-Data-and-Systems/Files-for-Order/LimitedDataSets/ASCPaymentSystem.html http://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/CERT/Part_A_to_Part_B_Rebilling_Demonstration.html http://www.cms.hhs.gov http://www.cms.hhs.gov/HospitalQualityInits/ http://www.cms.hhs.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalOutpatientPPS/index.html http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm311405.htm http://www.gpo.gov/fdsys/ http://www.gpo.gov/fdsys/pkg/FR-2012-07-30/pdf/2012-18433.pdf http://www.healthcare.gov/law/resources/reports/ http://www.healthcare.gov/law/resources/reports/quality03212011a.html http://www.hhs.gov/about/FY2012budget/strategicplandetail.pdf http://www.hhs.gov/secretary/about/priorities/strategicplan2010-2015.pdf http://www.hospitalcompare.hhs.gov http://www.medpac.gov/documents/Mar12_EntireReport.pdf http://www.qualityforum.org/ http://www.qualityforum.org/MeasureDetails.aspx?actid=0&SubmissionId=1121#k=0138&e=0&st=&sd=&s=n&so=a&p=1&mt=&cs=&ss= http://www.qualityforum.org/Measuring_Performance/Consensus_Development_Process%e2%80%99s_Principle/Public_and_Member_Comment.aspx http://www.qualityforum.org/Measuring_Performance/Improving_NQF_Process/Process_Assessment_Measure_Maintenance.aspx 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https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/InpatientRehabFacPPS/Downloads/IRFPAI-manual-2012.pdf https://www.qualitynet.org Vol. 77, no. 221 Office of the Federal Register, National Archives and Records Administration 2012-11-15 continuing daily deposited born digital 644 p. 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