Connecticut’s Medicare-based fee schedule for hospital inpatient, hospital outpatient, and ambulatory surgical center (ASC) services went into effect April 1.
Previously, there were no facility fee schedules in Connecticut and employers were liable for the hospitals’ prevailing charges unless the payers have negotiated discounted rates with the hospitals, according to the National Council on Compensation Insurance (NCCI).
Before, there was no facility fee schedule in Connecticut, though there has been one for physician fees, said Laura Backus Hall, NCCI’s state relations executive for Connecticut.
“A part of the facility fee schedule is that hospital outpatient services shall be reimbursed at 210 percent of Medicare’s outpatient fee schedule. That’s one of the features,” Hall said. “Another is that ambulatory surgical center services are to be reimbursed at 195 percent of Medicare’s outpatient fee schedule. And another feature is hospital inpatient services shall be reimbursed at 174 percent of Medicare’s Inpatient Prospective Payment System (IPPS).”
This new facility fee schedule is expected help lower medical costs, as reflected by the recently approved NCCI filing for decreases in advisory loss costs and assigned risk rates.
The NCCI made a law
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