Physician Resources

Curated public policy issues for AMITA Health's physician partners.

Surprise Billing

Surprise medical billing is a widespread and costly problem in the U.S. and there is bipartisan support that patients should not be subject to surprise medical bills over which they had no control. The COVID-19 pandemic underscores the urgency of addressing the issue and illustrates that action on surprise billing is possible.

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Medicare COVID-19 IPPS Add-on Guidance

On August 17, 2020 CMS issued a new requirement related to the 20% inpatient prospective payment system (IPPS) diagnosis-related group (DRG) rate add-on for patients diagnosed with COVID-19. For inpatient admissions occurring on or after Sept. 1, 2020, claims eligible for the 20% add-on will be required to have a positive COVID-19 laboratory test documented in patients’ medical records.

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CY2021 Outpatient Prospective Payment System (OPPS) Proposed Rule

CMS has issued the CY 2021 Outpatient Prospective Payment System (OPPS) proposed rule. Comments are due Oct. 5, 2020.  Highlights from the rule’s executive summary can be found here.

You can read the rule here.

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