United States General Accounting Office Washington, D.C. 20548

By Scully, Thomas A.

Book Id: WPLBN0000224383
Format Type: PDF eBook:
File Size: 0.4 MB
Reproduction Date: 2005

Title:	United States General Accounting Office Washington, D.C. 20548
Author:	Scully, Thomas A.
Volume:
Language:	English
Subject:	Government publications, Accountability in government, United States. General Accounting Office
Collections:	Government Library Collection, Government Accountability Integrity Reliability Office Collection
Historic Publication Date:
Publisher:	United States General Accounting Office (Gao)


Citation APA MLA Chicago A. Scull, B. T. (n.d.). United States General Accounting Office Washington, D.C. 20548. Retrieved from https://self.gutenberg.org/

Description
Government Accountability Integrity Reliability Office Collection

Excerpt
Excerpt: Under the Medicare hospital outpatient prospective payment system (OPPS), beneficiaries can be responsible for paying 50 percent or more of the total payment for outpatient services they receive in hospitals. The Balanced Budget Act of 1997 (BBA)1 introduced a mechanism to gradually decrease beneficiary cost sharing to 20 percent of the payment rate for each hospital outpatient service. The Centers for Medicare & Medicaid Services (CMS) published a final rule that implemented, effective with the 2002 payment rates, a methodology for calculating copayment amounts that was designed to ensure that even as certain changes affect the payment rates for hospital outpatient services over time, beneficiary coinsurance3 for services would eventually be 20 percent of the total payment rate for each service.4 Under this 2002 methodology, the copayment amount for each outpatient payment group of services, called an ambulatory payment classification (APC) group, could not increase from year to year, and the beneficiary coinsurance percentage would remain the same or decrease, eventually reaching 20 percent for each APC.5...