As was reported in the last edition of the WAO Advocacy Newsletter, last month the Centers for Medicare & Medicaid Services (CMS) released the 2024 proposed payment rule for Ambulatory Surgery Centers (ASC) and hospital outpatient departments (HOPD), which aims to update Medicare payment rates and policies under the Outpatient Prospective Payment System (OPPS) and ASC Payment System. CMS also issued the proposed 2024 update to the Medicare Physician Fee Schedule.

In the proposed ASC rule, CMS recommends updating the OPPS conversion factor by 2.8 percent, which includes a market basket increase of 3.0 percent and a productivity adjustment of negative 0.2 percent. CMS also proposes applying the 2.8 percent update to ASC payments in 2024. However, it is important to note that CMS does not consider sequestration in its proposed rule. This statutory 2.0 percent reduction remains in effect unless Congress acts.

Under the proposed Medicare Physician Fee Schedule, clinicians would see a 3.36% decrease to the physician conversion factor. The proposed conversion factor for 2024 is $32.75, which is a reduction compared to the 2023 conversion factor of $33.89.

The WAO will be submitting comments to CMS on both rules, outlining our concerns and other thoughts on the two proposals. The WAO will be using talking points from the American Academy of Ophthalmology to draft our comments, which will not only be submitted to CMS, but also shared with the WAO membership.

Both rules are open for public comment until Sept. 11. CMS has said it will issue the final rules in November.