Federal Register, Volume 75, Number 226, November 24, 2010, Pages 71519-72652 Page: 71,804
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71804 Federal Register/Vol. 75, No. 226/Wednesday, November 24, 2010/Rules and Regulations
3. Policies for Supervision of Outpatient
Therapeutic Services in Hospital and
CAHs
4. Supervision of Hospital Outpatient
Diagnostic Services
B. Payment for Preventive Services
1. Definition of "Preventive Services"
2. Coinsurance and Deductible for
Preventive Services
3. Extension of Waiver of Part B Deductible
to Services Furnished in Connection
With or in Relation to a Colorectal
Cancer Screening Test That Becomes
Diagnostic or Therapeutic
C. Payment for Pulmonary Rehabilitation,
Cardiac Rehabilitation, and Intensive
Cardiac Rehabilitation Services
Furnished to Hospital Outpatients
D. Expansion of Multiple Procedure
Payment Reduction Under the Medicare
Physician Fee Schedule (MPFS) to
Therapy Services
XIII. OPPS Payment Status and Comment
Indicators
A. OPPS Payment Status Indicator
Definitions
1. Payment Status Indicators To Designate
Services That Are Paid Under the OPPS
2. Payment Status Indicators To Designate
Services That Are Paid Under a Payment
System Other Than the OPPS
3. Payment Status Indicators To Designate
Services That Are Not Recognized Under
the OPPS But That May Be Recognized
by Other Institutional Providers
4. Payment Status Indicators To Designate
Services That Are Not Payable by
Medicare on Outpatient Claims
B. Comment Indicator Definitions
XIV. OPPS Policy and Payment
Recommendations
A. MedPAC Recommendations
B. APC Panel Recommendations
C. OIG Recommendations
XV. Updates to the Ambulatory Surgical
Center (ASC) Payment System
A. Background
1. Legislative Authority for the ASC
Payment System
2. Prior Rulemaking
3. Policies Governing Changes to the Lists
of Codes and Payment Rates for ASC
Covered Surgical Procedures and
Covered Ancillary Services
B. Treatment of New Codes
1. Process for Recognizing New Category I
and Category III CPT Codes and Level II
HCPCS Codes
2. Treatment of New Level II HCPCS Codes
and Category III CPT Codes Implemented
in April and July 2010 for Which We
Solicited Public Comments in Calendar
Year 2011 OPPS/ASC Proposed Rule
3. Process for New Level II HCPCS Codes
and Category I and Category III CPT
Codes for Which We Are Soliciting
Public Comments in This Calendar Year
2011 OPPS/ASC Final Rule With
Comment Period
C. Update to the List of ASC Covered
Surgical Procedures and Covered
Ancillary Services
1. Covered Surgical Procedures
a. Additions to the List of ASC Covered
Surgical Proceduresb. Covered Surgical Procedures Designated
as Office-Based(1) Background
(2) Changes to Covered Surgical Procedures
Designated as Office-Based for CY 2011
c. ASC Covered Surgical Procedures
Designated as Device-Intensive
(1) Background
(2) Changes to List of Covered Surgical
Procedures Designated as Device-
Intensive for CY 2011
d. ASC Treatment of Surgical Procedures
Removed From the OPPS Inpatient List
for CY 2011
2. Covered Ancillary Services
D. ASC Payment for Covered Surgical
Procedures and Covered Ancillary
Services
1. Payment for Covered Surgical
Procedures
a. Background
b. Update to ASC Covered Surgical
Procedure Payment Rates for CY 2011
c. Adjustment to ASC Payments for No
Cost/Full Credit and Partial Credit
Devices
d. Waiver of Coinsurance and Deductible
for Certain Preventive Services
2. Payment for Covered Ancillary Services
a. Background
b. Payment for Covered Ancillary Services
for CY 2011
E. New Technology Intraocular Lenses
(NTIOLs)
1. Background
2. NTIOL Application Process for Payment
Adjustment
3. Classes of NTIOLs Approved and New
Requests for Payment Adjustment
a. Background
b. Request To Establish New NTIOL Class
for CY 2011
4. Payment Adjustment
5. ASC Payment for Insertion of IOLs
6. Announcement of Calendar Year 2011
Deadline for Submitting Request for CMS
Review of Appropriateness of ASC
Payment for Insertion of an NTOL
Following Cataract Surgery
F. ASC Payment and Comment Indicators
1. Background
2. ASC Payment and Comment Indicators
G. ASC Policy and Payment
Recommendations
H. Calculation of the ASC Conversion
Factor and the ASC Payment Rates
1. Background
2. Calculation of the ASC Payment Rates
a. Updating the ASC Relative Payment
Weights for CY 2011 and Future Years
b. Updating the ASC Conversion Factor
3. Display of Calendar Year 2011 ASC
Payment Rates
XVI. Reporting Quality Data for Annual
Payment Rate Updates
A. Background
1. Overview
2. Hospital Outpatient Quality Data
Reporting under Section 109(a) of MIEA-
TRHCA
3. ASC Quality Data Reporting Under
Section 109(b) of MIEA-TRHCA
4. HOP QDRP Quality Measures for the CY
2009 Payment Determination
5. HOP QDRP Quality Measures for the CY
2010 Payment Determination6. HOP QDRP Quality Measures, Technical
Specification Updates, and DataPublication for the CY 2011 Payment
Determination
a. Quality Measures
b. Maintenance of Technical Specifications
for Quality Measures
c. Publication of HOP QDRP Data
B. Expansion of HOP QDRP Quality
Measures for the CY 2012, CY 2013, and
CY 2014 Payment Determinations
1. Considerations in Expanding and
Updating Quality Measures Under the
HOP QRDP
2. Retirement of HOP QDRP Quality
Measures
3. HOP QDRP Quality Measures for the CY
2012 Payment Determination
a. Retention of Existing HOP QDRP
Measures for the CY 2012 Payment
Determination
b. New Structural Measure for CY 2012
Payment Determination
c. New Claims-Based Measures for CY 2012
Payment Determination
d. New Chart-Abstracted Measures for CY
2012 Payment Determination
4. HOP QDRP Quality Measures for the CY
2013 Payment Determination
a. Retention of CY 2012 HOP QDRP
Measures for the CY 2013 Payment
Determination
b. New Structural Measure for the CY 2013
Payment Determination
c. New Chart-Abstracted Measures for the
CY 2013 Payment Determination
5. HOP QDRP Quality Measures for the CY
2014 Payment Determination
a. Retention of CY 2013 HOP QDRP
Measures for the CY 2014 Payment
Determination
b. New Chart-Abstracted Measures for the
CY 2014 Payment Determination
6. Possible Quality Measures Under
Consideration for Future Inclusion in the
HOP QDRP
C. Payment Reduction for Hospitals That
Fail To Meet the HOP QDRP
Requirements for the CY 2011 Payment
Update
1. Background
2. Reporting Ratio Application and
Associated Adjustment Policy for CY
2011
D. Requirements for HOPD Quality Data
Reporting for CY 2012 and Subsequent
Years
1. Administrative Requirements
2. Data Collection and Submission
Requirements
a. General Data Collection and Submission
Requirements
b. Extraordinary Circumstance Extension
or Waiver for Reporting Quality Data
3. HOP QDRP Validation Requirements for
Chart-Abstracted Data: Data Validation
Approach for CY 2012 and Subsequent
Years
a. Background
b. Data Validation Requirements for CY
2012
c. Additional Data Validation Conditions
Under Consideration for CY 2013 and
Subsequent Years
E. HOP QDRP Reconsideration and
Appeals ProceduresF. Reporting of ASC Quality Data
G. Electronic Health Records
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United States. Office of the Federal Register. Federal Register, Volume 75, Number 226, November 24, 2010, Pages 71519-72652, periodical, November 24, 2010; Washington D.C.. (https://digital.library.unt.edu/ark:/67531/metadc52807/m1/293/: accessed April 25, 2024), University of North Texas Libraries, UNT Digital Library, https://digital.library.unt.edu; crediting UNT Libraries Government Documents Department.