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 2015_register executive 2018-03-01 article Part II Rules and Regulations D09002ee1c7f6e653 D09002ee1c7f6e717 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 2016 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 and the ASC Quality Reporting (ASCQR) Program. Further, this document includes certain finalized policies relating to the hospital inpatient prospective payment system: Changes to the 2- midnight rule under the short inpatient hospital stay policy; and a payment transition for hospitals that lost their status as a Medicare- dependent, small rural hospital (MDH) because they are no longer in a rural area due to the implementation of the new Office of Management and Budget delineations in FY 2015 and have not reclassified from urban to rural before January 1, 2016. In addition, this document contains a final rule that finalizes certain 2015 proposals, and addresses public comments received, relating to the changes in the Medicare regulations governing provider administrative appeals and judicial review relating to appropriate claims in provider cost reports. 80 FR 70298 https://www.govinfo.gov/app/details/FR-2015-11-13/2015-27943 2015-27943 fr13no15-8 RIN 0938-AS42 RIN 0938-AS11 4120-01-P CMS-1633-FC CMS-1607-F2 https://www.govinfo.gov/app/details/FR-2015-11-13/2015-27943 https://www.govinfo.gov/content/pkg/FR-2015-11-13/html/2015-27943.htm https://www.govinfo.gov/content/pkg/FR-2015-11-13/pdf/2015-27943.pdf Administrative Practice and Procedure Health Facilities Health Professions Kidney Diseases Medicare Reporting and Recordkeeping Rural Areas X-Rays Laboratories Puerto Rico Reporting and Recordkeeping Requirements Hospitals 310 p. 70298 70607 80 FR 70298 Title 42 Part 405 42 CFR Part 405 Title 42 Part 410 42 CFR Part 410 Title 42 Part 412 42 CFR Part 412 Title 42 Part 413 42 CFR Part 413 Title 42 Part 416 42 CFR Part 416 Title 42 Part 419 42 CFR Part 419 RIN 0938-AS42 RIN 0938-AS11 Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Short Inpatient Hospital Stays; Transition for Certain Medicare-Dependent, Small Rural Hospitals Under the Hospital Inpatient Prospective Payment System; Provider Administrative Appeals and Judicial Review; Federal Register Vol. 80, Issue RULE 2015-27943 II DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services CMS-1633-FC CMS-1607-F2 4120-01-P 2015-27943 Final rule with comment period; final rule.

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 2016 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 and the ASC Quality Reporting (ASCQR) Program. Further, this document includes certain finalized policies relating to the hospital inpatient prospective payment system: Changes to the 2- midnight rule under the short inpatient hospital stay policy; and a payment transition for hospitals that lost their status as a Medicare- dependent, small rural hospital (MDH) because they are no longer in a rural area due to the implementation of the new Office of Management and Budget delineations in FY 2015 and have not reclassified from urban to rural before January 1, 2016. In addition, this document contains a final rule that finalizes certain 2015 proposals, and addresses public comments received, relating to the changes in the Medicare regulations governing provider administrative appeals and judicial review relating to appropriate claims in provider cost reports.

Effective Date: This final rule with comment period and final rule are effective on January 1, 2016. Advisory Panel on Hospital Outpatient Payment (HOP Panel), contact Carol Schwartz at (410) 786-0576. 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www.qualityforum.org/WorkArea/linkit.aspx?LinkIdentifier=id&ItemID=78318 Vol. 80, no. 219 Office of the Federal Register, National Archives and Records Administration 2015-11-13 continuing daily deposited born digital 523 p. 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