MedPAC on OPPS outliers
This article was originally published in The Gray Sheet
Executive Summary
Hospital outlier policy should be disbanded, the Medicare Payment Advisory Commission formally recommends in its 1March report to Congress. Citing research showing that low-cost procedures with payment rates of $300 or less took the bulk of outlier payments in 2002, the commission contends the policy designed to provide additional payments for extremely costly cases is not being used as intended (2"The Gray Sheet" Jan. 19, 2004, p. 14)...