2018 OPPS Final Rule: Implement 340B Changes and Other Major Provisions - On-Demand

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2018 OPPS Final Rule: Implement 340B Changes and Other Major Provisions - On-Demand

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2018 OPPS Final Rule: Implement 340B Changes and Other Major Provisions - On-Demand

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Available ON-DEMAND

Presented on:
Friday, December 8, 2017

Presented by:
Jugna Shah, MPH
Valerie A. Rinkle, MPA 

Level of Program:

Sponsored by:

The 2018 OPPS final rule is one of the most controversial in recent years, with CMS finalizing a policy to drastically cut payments for drugs purchased under the 340B drug discount program by average sales price (ASP) minus 22.5% from the current ASP plus 6%. This policy will not only have a large financial impact on hospitals, but will also add potential regulatory burden, as providers will be required to report modifiers on separately payable drugs purchased through the program.

During this program, expert speakers Jugna Shah, MPH, and Valerie A. Rinkle, MPA, will analyze the final rule and deliver a comprehensive program on how providers can prepare for the major changes coming in 2018, including how to assess the impact and implement changes related to 340B drug reporting.

Shah and Rinkle will also review relevant policies described in the Medicare Physician Fee Schedule (MPFS) final rule that impact outpatient hospital services, including updated payment policies for non-excepted, off-campus outpatient departments. Other 2018 changes to be discussed include updates to the inpatient-only list, skin substitute packaging, and reporting of certain clinical diagnostic laboratory tests.

At the conclusion of this program, participants will be able to:

  • Describe changes to the 340B drug discount program and reporting requirements of two new modifiers
  • Determine the impact of packaging low-level drug administration services
  • Identify services that have been removed or added to the inpatient-only list for 2018
  • Report laboratory services according to CMS’ updated policy

Who Should Listen?

  • HIM directors and staff
  • Outpatient coding managers and staff
  • Billing managers and staff
  • Revenue cycle professionals
  • Chargemaster coordinators
  • Auditors
  • APC coordinators
  • Compliance officers
  • Finance staff
  • Revenue integrity professionals


This program will cover: 

  • Payment reductions for the 340B drug discount program
    • Drugs and facilities excepted from this policy
    • CMS’ payment and informational modifiers for drugs that are part of the program
  • Packaging policies
    • Addition of low-level drug administration services
    • Increased drug packaging threshold
  • Billing and payment for laboratory services
    • Modifications to current date of service policy
    • Regulations for molecular pathology and advanced diagnostic laboratory tests
  • Other key changes related to charging, coding, and billing outpatient services
    • Inpatient-only list updates
    • Chronic care management codes
    • New APC for imaging without contrast
    • Status indicator changes
  • Major policies in the 2018 MPFS that impact outpatient hospital services
    • Non-excepted, off-campus provider-based department payment
    • Appropriate Use Criteria
    • Medicare Diabetes Prevention Program

A live question-and-answer session will follow the presentation.

Continuing Education

(Live + On Demand) - This program has the prior approval of AAPC for 2.0 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor. (Ability to claim CEH’s for this webinar expires on: 12/7/18)

American Health Information Management Association (AHIMA)
(Live + On Demand) - This program has been approved for 2.0 continuing education units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting prior approval from AHIMA does not constitute endorsement of the program content or its program sponsor. (Ability to claim CEU’s for this webinar expire on: 12/7/18)

Meet the Speakers

Jugna Shah
Jugna Shah, MPH,
is the president and founder of Nimitt Consulting, Inc., a firm specializing in case-mix payment system design, development, and implementation. She has extensive experience working with providers on the ongoing clinical, operational, and financial implications of Medicare’s OPPS based on APCs. She has educated and audited numerous hospitals on their drug administration coding and billing practices. She has contributed to several books and numerous OPPS/APC articles over the past 13 years. She is also a contributing editor of HCPro's Briefings on APCs.

Valerie RinkleValerie A. Rinkle, MPA, is a lead regulatory specialist and an instructor for HCPro's Medicare Boot Camp®—Revenue Integrity and Chargemaster Version, Medicare Boot Camp®—Utilization Review Version, and Medicare Boot Camp®—Hospital Version. Rinkle is a former hospital revenue cycle director and has over 30 years in the healthcare industry, including over 12 years of consulting experience in which she has spoken and advised on effective operational solutions for compliance with Medicare coverage, payment, and coding regulations.

Webinar system requirements and program materials: 

To fully benefit from the webinar experience, please note you will need a computer equipped with the following: 

Browser: Microsoft Internet Explorer 6 or later, Firefox, Chrome, or Safari, with JavaScript enabled 
Internet: 56K or faster Internet connection (high-speed connection recommended) 
Streaming: for audio/video streaming, Adobe Flash plug-in or Safari browser on iOS devices 

Prior to the webinar, you will receive an email with detailed system requirements, your login information, presentation slides, and other materials that you can print and distribute to all attendees at your location. 

No problem. The On-Demand version is now available. Use it as a training tool at your convenience—whenever your new or existing staff need a refresher or need to understand a new concept. Play it once or dozens of times. A $299 value! 

Participation in the webinar is just $299 per site. All materials must be retrieved from the Internet. 

Call your customer service representative toll-free 800-650-6787 or email customerservice@hcpro.com if you have questions.