After what must have been significant feedback, the Centers for Medicare & Medicaid Services is now reversing its move to eliminate the inpatient only (IPO) list in 2022 and add back the 298 services removed from the IPO list in 2021. 1 If this goes through in 2022, it will require hospitals to be extra diligent in their leveling of care for traditional Medicare patients.
CMS is also seeking input on the future of the IPO list. We are currently in the 60-day comment period, for the proposed changes to CMS-1753-P which will end on September 17, 2021. The final rule with comment period will be issued in early November 2021. CMS received a large number of stakeholder comments following issuance of the final rule that opposed the elimination of the IPO list primarily due to patient safety concerns, stating that the IPO list serves as an “important programmatic safeguard.” It is important for hospitals to voice their concerns and opinions on proposed regulatory changes.2
Comments can be made at: https://www.regulations.gov/document/CMS-2021-0124-0001.
CMS states, “This change in policy would ensure that any service removed from the IPO list has been reviewed against Medicare’s longstanding IPO list criteria to determine if it is appropriate for Medicare to pay for the provision of the service in the outpatient setting. Furthermore, CMS is proposing to codify the longstanding criteria for removal of procedures from the IPO list to make clear in regulatory text how we will evaluate future procedures for removal.”
There is likely to be many pleased with this decision including the American Hospital Associaton, AAOS and others including the major orthopaedic societies who have been concerned about the list elimination since the high-profile 2019 removal of Total Hip Arthroplasty and the earlier removal of the Total Knee Arthroplasty from inpatient only list.
SOURCES
- From https://public-inspection.federalregister.gov/2021-15496.pdf
- From https://www.cms.gov/newsroom/fact-sheets/cy-2022-medicare-hospital-outpatient-prospective-payment-system-and-ambulatory-surgical-center
ADDITIONAL SOURCES:
Trotter, Zachary “CMS reverses course on elimination of the inpatient only service list” August5, 2021. Waller.com https://www.wallerlaw.com/news-insights/3956/CMS-reverses-course-on-elimination-of-the-inpatient-only-service-list-