- Mission [1]
- The Advisory Panel on Ambulatory Payment Classification Groups (APCs) (the Panel) shall advise the Secretary and the Administrator,
Centers for Medicare & Medicaid Services (CMS), about the clinical integrity of the APC groups and their associated weights,
which are major elements of the Medicare hospital OPPS. The Panel is technical in nature, and it shall deal with the following
issues:•Addressing whether procedures within an APC group are similar both clinically and in terms of resource use. •Evaluating
APC group weights.•Reviewing the packaging of OPPS services and costs, including the methodology and the impact on APC groups
and payment. •Removing procedures from the inpatient list for payment under the OPPS.•Using single and multiple procedure
claims data for determination of APC group payments.•Addressing other technical issues concerning APC group structure.The
subject matter before the Panel shall be limited to these and related topics. Unrelated topics are not subjects for discussion.
Unrelated topics include, but are not limited to, the conversion factor, charge compression, pass-through payments for medical
devices and drugs, correct code usage, and wage adjustments.The Panel may use data collected or developed by entities and
organizations other than the DHHS and CMS in conducting its review. The Secretary and the Administrator shall be advised of
all matters pertaining to the Panel (i.e., membership, recommendations, subcommittees, meetings, etc.).
|
