CMS is expected to publish soon, a proposed Medicare hospital outpatient prospective payment system rule to revise the policies that govern payments to hospitals for services to outpatients. A final rule due on/or about November 1st should for the most part, become effective January 1, 2007.

Some of what the rule can be expected to address:
· A potential overall reduction factor to account for high OPD utilization that is pushing costs to all-time highs
· Changes to the ambulatory payment classification (APC) groups and relative weights
· Procedure movement between APCs
· Policy modifications for drugs, radiopharmaceuticals, and blood products
· Rural vs. other payment issues
· Outlier policy changes
· Partial hospitalization payments