CMS Issues CY 2023 Hospital Outpatient Payment Proposed Rule; Includes Additional Rural Emergency Hospital (REH) Provisions

This afternoon, the Centers for Medicare and Medicaid Services released the calendar year (CY) 2023 Hospital Outpatient Prospective Payment System (OPPS) proposed rule.  While physician payments under the Medicare Physician Fee Schedule continue to be cut due to statutory budget neutrality provisions, CMS proposes to increase hospital outpatient payments by 2.7%. 

Also included in this proposed rule are several new provisions for Rural Emergency Hospitals (REHs). Congressionally-created in the Consolidated Appropriations Act, 2021, REH is the new enrollment designation for hospitals that “were CAHs [critical access hospitals] or rural hospitals with not more than 50 beds, participating in Medicare, as of the date of enactment” (December 27, 2020) and wish to convert to and enroll in Medicare as an REH. REHs must provide emergency and observation care. As you will recall, we recently announced a proposed rule directed at the Conditions of Participation (CoPs) for REHs.  The provisions included here in the CY 2023 OPPS proposed rule are directed at REH enrollment, payment, and quality reporting.  A CMS fact sheet on REHs is available here.  CMS notes that it will finalize the REH CoPs with the enrollment, payment, and quality reporting provisions later this Fall. 

For those interested in more details, CMS also issued a related press release and fact sheet  

EDPMA will continue to review all of the provisions of the rule and provide additional details.  EDPMA plans to file comments on the proposed rule by the September 13, 2022 deadline.