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医疗保险计划;1998年10月1日起生效的门诊手术中心费率设定方法、支付费率、支付政策及涵盖的外科手术清单更新——医疗保健财务管理局。拟议规则。

Medicare program; update of ratesetting methodology, payment rates, payment policies, and the list of covered surgical procedures for ambulatory surgical centers effective October 1, 1998--HCFA. Proposed rule.

出版信息

Fed Regist. 1998 Jun 12;63(113):32290-521.

Abstract

In this rule we propose to--Update the criteria for determining which surgical procedures can be appropriately and safely performed in an ambulatory surgical center (ASC); Make additions to and deletions from the current list of Medicare covered ASC procedures based on the revised criteria; Rebase the ASC payment rates using cost, charge, and utilization data collected by a 1994 survey of ASCs; Refine the ratesetting methodology that was implemented by a final notice published on February 8, 1990 in the Federal Register; Require that ASC payment, coverage, and wage index updates be implemented annually on January 1 rather than having these updates occur randomly throughout the year; Reduce regulatory burden; and Make several technical policy changes. This proposed rule implements requirements of section 1833(i)(1) and (2) of the Social Security Act.

摘要

在本规则中,我们提议:更新确定哪些外科手术可在门诊手术中心(ASC)适当且安全地进行的标准;根据修订后的标准,对医疗保险涵盖的ASC手术当前清单进行增减;利用1994年对ASC的调查收集的成本、收费和使用数据重新确定ASC支付费率;完善1990年2月8日在《联邦公报》上发布的最终通知所实施的费率设定方法;要求ASC支付、保险范围和工资指数更新于每年1月1日实施,而非全年随机进行;减轻监管负担;并进行若干技术政策变更。本拟议规则实施了《社会保障法》第1833(i)(1)和(2)条的要求。

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