December 8, 2023
As part of its advocacy collaboration with a large group of wound care/HBO stakeholders, the Alliance, submitted comments to CMS requesting an immediate correction to the payment rate for hyperbaric oxygen (“HBO”) therapy included in the 2024 Hospital Outpatient Prospective Payment System rule. In the final rule published in November, "CMS unexpectedly, and without explanation, implemented a reduction of over 40% to the CY 2024 OPPS payment rate for HBO therapy, compared to the CY 2023 OPPS payment rate. We believe that an error was made in the calculation and publication of this payment rate in the 2024 OPPS Final Rule, and we respectfully request that CMS take immediate action to issue a correction," the Alliance wrote, reminding the Agency that implementing this level of payment reduction through the final rule without the opportunity for public comment clearly violates the notice-and-comment rulemaking requirements of the Administrative Procedure Act. HBO has fixed costs "which cannot absorb the cut in the CY 2024 OPPS Final Rule," wrote the Alliance, emphasizing the negative patient care impacts as well as HBO site closures that could result. As part of its collaboration with a range of organizations in this space, the Alliance engaged independent reviewers to analyze the root cause of the drastic decrease in payment rate. The independent review analyzed outpatient claims and concluded that the final cost estimate that CMS provided with the final rule was most likely an error. The review was submitted with Alliance comments urging CMS to review its calculations of the cost, and thus the payment, for HBOT.

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