Outpatient Prospective Payments in 2019

Presented on:
January 22, 2019 9:00 AM PT
1 hour

The Centers for Medicare & Medicaid Services (CMS) are making significant changes to the Outpatient Prospective Payment System—some of which go into effect on January 1, 2019. As CMS continues to review their policies and reimbursement for clinical services in hospital outpatient settings in the coming year, providers will be increasingly accountable for maintaining appropriate documentation of attestations for locations and modifiers on claims as well as managing constant changes in reimbursement for patient care services and 340B pharmaceuticals.

Join us for a webcast that will help you stay current on these changes. We’ll review the current landscape and discuss how providers can position themselves in 2019 to mitigate any unintended consequences of operational changes.



Paul Holden, Partner, Moss Adams

Paul is a member of the firm’s Health Care Consulting practice, where he provides reimbursement, business intelligence and operational consulting services to health care providers in acute and post-acute settings throughout the West. Paul has more than 15 years of health care experience, is a member of the Moss Adams Health Care Industry Group Leadership Team and has served in board roles for the Healthcare Financial Management Association (Oregon and Washington/Alaska Chapters), arts-based schools and currently for the Legacy-Good Samaritan Hospital Foundation in Portland, Oregon. He is a frequent presenter to health care lobbying and trade groups on emerging issues and complex technical topics.

Lawrence W. Vernaglia, Partner, Foley & Lardner, LLP

Lawrence Vernaglia is a partner and health care lawyer with Foley & Lardner LLP and serves as chair of the firm’s Health Care Practice and Health Care Industry Team – named “Health Law Firm of the Year” by U.S. News - Best Lawyers® on the "Best Law Firms" list (2012 – 2014). Mr. Vernaglia represents hospitals, health systems and academic medical centers and a variety of other health care providers. Mr. Vernaglia's practice involves regulatory and transactional matters, including Medicare/Medicaid reimbursement compliance advice and appeals; mergers, acquisitions and financings; state regulatory issues including licensing, change of ownership, and CoN/DoN; survey/certification appeals; fraud & abuse/Stark law analyses; managed care contracting; and general corporate and business planning in health care. He runs strategic planning programs for senior management and governing boards.

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