Ambulatory Payment Classification Meeting In Brief
This article was originally published in The Gray Sheet
Executive Summary
No floor for payment drops: APC advisory panel will not recommend that CMS limit payment decreases in its 2007 outpatient rule as the agency has in past years. In 2006, median costs for device-dependent APCs could not decline more than 10% from the previous year (1"The Gray Sheet" Aug. 14, 2006, p. 4). The Medical Device Manufacturers Association told the panel Aug. 24 in Baltimore, Md., that large drops in payment "perpetuate unpredictability in reimbursement and will lead to limited patient access to high-technology devices and procedures." According to CMS' proposed rule, released Aug. 8, only six APCs will see declines of more than 10% in median costs in 2007. "These devices were artificially inflated through the pass-through [payments]," suggested agency staffer Anita Heygster. She said that the reduced payments may simply reflect the appropriate relative estimated costs for the procedures...