2021 OPPS Rule: Future Implications of CMS Reimbursement

Presented on:
January 14, 2021 9:00 AM PT
1 hour, 30 minutes

The Centers for Medicare & Medicaid Services (CMS) finalized nearly all proposals with few changes in the 2021 OPPS and Medicare Physician Fee Schedule final rules. These changes take effect January 1, 2021.

As CMS continues to review their policies and reimbursement for clinical services in hospital outpatient settings in 2021, providers will be increasingly accountable for maintaining documentation of attestations for locations and modifiers on claims. They’ll also need to manage constant changes in reimbursement for patient care services and 340B pharmaceuticals.

Join us for a comprehensive overview of the updates and a discussion of how these changes may present operational challenges for hospitals in 2021.

Our keynote presenters include:

  • Lawrence Vernaglia, Partner and Former Department Chair, Foley & Lardner’s Health Care Industry Team
  • Valerie A. Rinkle, MPA, CHRI, President, Valorize Consulting LLC
  • Paul Holden, FHFMA, Partner, Co-Leader, Provider Reimbursement Enterprise Services, Moss Adams Health Care Consulting


Lawrence Vernaglia, Partner and Former Health Care Industry Team Department Chair, Foley & Lardner

Lawrence Vernaglia is a partner and health care lawyer with Foley & Lardner LLP where he is the department chair for the firm’s Industry Teams Department, responsible for overall strategy and leadership across all industry teams. Prior to that, he served for eight years as chair of the firm’s Health Care Industry Team. Lawrence represents hospitals, health systems, and academic medical centers and a variety of other health care providers.

Valerie A. Rinkle, MPA, CHRI, President, Valorize Consulting LLC

Valerie Rinkle, MPA, CHRI is President of Valorize Consulting and has more than 35 years of experience in healthcare policy, finance, strategy, and revenue management operations. Her expertise spans all CMS reimbursement methodologies and the operational capabilities necessary to effectively achieve accurate and defensible payment. She has extensive hospital chargemaster, OPPS and physician fee schedule, and provider-based department experience.

Paul Holden, FHFMA, Partner, Health Care Consulting, Moss Adams

Paul has been in public accounting since 2003. He provides business assurance and reimbursement consulting services to health care providers in acute and post-acute settings throughout the western United States. Paul is well-versed in preparing Medicare and Medicaid cost reports, assisting clients during third-party audits, formulating appeals of audit issues in connection with cost reports, and assisting Critical Access Hospitals, Rural Health Clinics, and Federally Qualified Health Centers with billing and reimbursement issues.

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