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On July 26, 2022, the Centers for Medicaid and Medicare (“CMS”) published the 2023 Hospital Outpatient Prospective PaymentSystem (OOPS) and Ambulatory Surgery Center PaymentSystem Proposed Rule.
Medicare and Medicaid may have different paymentsystems from those of the private health insurance plans. The lack of documentation may result in an audit, leading to claim denial and fines for noncompliance with Medicare and Medicaid regulations.
In the 2023 Outpatient Prospective PaymentSystem Final Rule (OPPS Final Rule), released in pre-publication form on November 1, 2022, the Centers for Medicare and Medicaid Services (CMS) adopts final regulations governing REHs.
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