BREAKING NEWS: CMS to Reinstate Inpatient-Only List

In an unprecedented move, the Centers for Medicare & Medicaid Services (CMS) has proposed in the 2022 Outpatient Prospective Payment System (OPPS) Rule to put back on the inpatient only list all the procedures that they removed from the inpatient only list starting this calendar year.

The agency has also put a halt to its three year-plan to completely eliminate the inpatient only list. It appears that its motivation is to protect the safety of Medicare beneficiaries and take a more cautious approach to removing services from the inpatient only list looking at them on a n individual basis rather than by class.

“Since there are still five months left in the year, it is unclear what physicians and hospitals should do with this information now,” said Ronald Hirsch, MD, vice president of regulations for R1 RCM Inc. “Since the audit moratorium remains in place for all of the procedures removed this year, and CMS has admitted proceeding too quickly with the removal process, it may be reasonable to tell physicians to disregard the complicated decision-making process that we wanted them to undertake and go back to admitting everybody as an inpatient starting today.”

On the other hand, cautioned Hirsch, “is it a compliance issue to ignore the status recommendations that are still technically and legally in place? I think this is a question that every compliance officer in the country is going to have to assess and decide upon very quickly.”  

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The full proposed rule can be found at: https://public-inspection.federalregister.gov/2021-15496.pdf